Community pharmacy and general practice collaborative and integrated working: a realist review protocol

Emily Claire Owen; Ruth Abrams; Ziyue Cai; Claire Duddy; Nina Fudge; Julia Hamer-Hunt; Fran Husson; Kamal Ram Mahtani; Margaret Ogden; Deborah Swinglehurst; Malcolm Turner; Cate Whittlesea; Geoff Wong; Sophie Park

doi:10.1136/bmjopen-2022-067034

Community pharmacy and general practice collaborative and integrated working: a realist review protocol

BMJ Open. 2022 Dec 29;12(12):e067034. doi: 10.1136/bmjopen-2022-067034.

Authors

Emily Claire Owen¹, Ruth Abrams², Ziyue Cai³, Claire Duddy⁴, Nina Fudge⁵, Julia Hamer-Hunt^{6

7}, Fran Husson^{6

8}, Kamal Ram Mahtani⁴, Margaret Ogden⁶, Deborah Swinglehurst⁵, Malcolm Turner⁶, Cate Whittlesea³, Geoff Wong⁴, Sophie Park⁶

Affiliations

¹ Department of Primary Care & Population Health, University College London, London, UK emily.owen@ucl.ac.uk.
² School of Health Sciences, University of Surrey, Surrey, UK.
³ Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK.
⁴ Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
⁵ Wolfson Institute of Population Health, Queen Mary University of London, London, UK, London, UK.
⁶ Department of Primary Care & Population Health, University College London, London, UK.
⁷ Department of Psychiatry, University of Oxford, Oxford, UK.
⁸ Faculty of Medicine, Imperial College London, London, UK.

Abstract

Introduction: Increasing collaborative and integrated working between General practice (GP) and Community pharmacy (CP) is a key priority of the UK National Health Service and has been proposed as a solution to reducing health system fragmentation, improving synergies and coordination of care. However, there is limited understanding regarding how and under which circumstances collaborative and integrated working between GP and CP can be achieved in practice and how regulatory, organisational and systemic barriers can be overcome.

Methods and analysis: The aim of our review is to understand how, when and why working arrangements between GP and CP can provide the conditions necessary for optimal communication, decision-making, and collaborative and integrated working. A realist review approach will be used to synthesise the evidence to make sense of the complexities inherent in the working relationships between GP and CP. Our review will follow Pawson's five iterative stages: (1) finding existing theories; (2) searching for evidence (our main searches were conducted in April 2022); (3) article selection; (4) data extraction and (5) synthesising evidence and drawing conclusions. We will synthesise evidence from grey literature, qualitative, quantitative and mixed-methods research. The research team will work closely with key stakeholders and include patient and public involvement and engagement throughout the review process to refine the focus of the review and the programme theory. Collectively, our refined programme theory will explain how collaborative and integrated working between GP and CP works (or not), for whom, how and under which circumstances.

Ethics and dissemination: Formal ethical approval is not required for this review as it draws on secondary data from published articles and grey literature. Findings will be widely disseminated through: publication in peer-reviewed journals, seminars, international conference presentations, patients' association channels, social media, symposia and user-friendly summaries.

Prospero registration number: CRD42022314280.

Keywords: Organisation of health services; PRIMARY CARE; Public health; Quality in health care.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Family Practice
General Practice*
Humans
Pharmacies*
Review Literature as Topic
State Medicine