The integration of pharmacists in the Australian general practice setting : implementation, evaluation and development of an evidence-based training program

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Background: Traditionally pharmacists have predominantly worked in community and hospital pharmacy settings. A recently expanding area of pharmacist practice is the provision of services by pharmacists integrated in general practice. General practice pharmacy is expanding worldwide with significant programs currently operating in the United Kingdom, the United States of America and Canada. In Australia, pharmacists have been employed in the general practice setting for some time, but this has previously been on a small scale, and focused around the funded services of home medicines review. More recently, project funding from Primary Health Networks (PHNs) has enabled the employment of larger numbers of general practice pharmacists across multiple states and regions of Australia. One such project is the WentWest General Practice Pharmacist project, which commenced in selected general practices across Western Sydney, New South Wales in 2016. Objectives: This thesis covers the synthesis, analysis and development of knowledge relating to the implementation of a GP pharmacist intervention in the Australian context and the development of an evidence-based education program for these pharmacists. Methodology: Mixed methodologies were employed. A process evaluation and a further two prospective observational studies were conducted to evaluate the GP pharmacist intervention. A systematic narrative review of the literature was conducted to allow the GP pharmacist scope of practice and competency map to be defined. A Delphi validation study was used to develop an expert consensus position on GP pharmacist educational needs and finally a theoretical work was produced outlining the educational program development. Results: Evaluation of the WentWest GP Pharmacist Project enabled identification of barriers and facilitators of the intervention. (Chapters 3-5) The lack of specific training for GP pharmacists was identified as a significant barrier to the intervention and this led to a narrowing of the research focus. The GP pharmacist scope of practice and competency map was defined. (Chapter 6) Educational needs of pharmacists wishing to practice as GP pharmacists were identified. (Chapter 7) An evidence-based educational program for GP pharmacists was developed. (Chapter 8) Conclusion: The results from the evaluation of the WentWest GP Pharmacist Project enabled adjustment and improvements to the intervention model and have been used to inform ongoing research. In addition, the research conducted into the GP pharmacist scope of practice and educational needs has enabled the development of the first comprehensive evidence-based education program for GP pharmacists in Australia.
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