Pharmacist's identity development within multidisciplinary primary health care teams in Ontario; qualitative results from the IMPACT project.

Background: Multidisciplinary team development generates changes in roles, responsibilities, and identities of individual health care providers. The Integrating Family Medicine and Pharmacy to Advance Primary Care Therapeutics (IMPACT) project introduced pharmacists into family practice teams across Ontario, Canada, to provide medication assessments, drug information, and academic detailing and to develop office system enhancements to improve drug therapy.

Objective: To analyze pharmacists' narrative accounts during early integration to study identity development within emerging team-based care.

Integrating pharmacists into family practice teams: physicians' perspectives on collaborative care.

Objective: To explore family physicians' perspectives on collaborative practice 12 months after pharmacists were integrated into their family practices.

Design: Qualitative design using focus groups followed by semistructured interviews.

Setting: Seven physician-led group family practices in urban, suburban, and semirural Ontario communities.

Do patients' expectations influence their use of medications? Qualitative study.

Objective: To investigate whether patients' expectations influence how they take their medications by looking at the expectations patients have of their medications and the factors that affect these expectations.

Design: Qualitative study using in-depth interviews and a grounded-theory approach.

Setting: A large city in Ontario.

Narrative reports to monitor and evaluate the integration of pharmacists into family practice settings.

Purpose: Narratives can capture unfolding events and negotiation of roles and thus can help to evaluate interventions in interdisciplinary health care teams. We describe a practical qualitative method, the narrative report, and its role in evaluating implementation research.

Methods: We used narrative reports as a means to evaluate an intervention to integrate pharmacists into group family practices.

Developing a tool to measure contributions to medication-related processes in family practice.

Successful team care requires a shared understanding of roles and expertise. This paper describes the development and preliminary exploration of the psychometric properties of a tool designed to measure contributions to family practice medication-related processes. Our team identified medication-related processes commonly occurring in family practice.

Prescribing of potentially inappropriate medications to elderly people.

Objective: To estimate the prevalence and predictors of medications deemed potentially inappropriate for the elderly among family physicians' patients aged 65 and older (seniors) taking multiple prescribed medications.

Methods: Forty-eight randomly selected family practices in 16 towns and cities in Southern Ontario, Canada and 889 of their senior patients were recruited into a randomized trial. We conducted a cross-sectional analysis of prescription insurance data from the provincial universal prescription insurance database over 12 months, from the 777 seniors who completed the trial and agreed to have their data released.

Collaboration between community pharmacists and family physicians: lessons learned from the Seniors Medication Assessment Research Trial.

Objectives: To learn about the experiences of specially trained expanded role pharmacists (ERPs) and family physicians in a program in which they worked together to optimize drug therapy for elderly patients (aged 65 and older) and to identify shortcomings of the program, obstacles to its implementation, and strategies to overcome these obstacles.

Design: Qualitative opinion analysis.

Participants: Six family physicians and six community-based ERPs who had participated in a randomized controlled trial (Seniors Medication Assessment Research Trial [SMART]).

Coding accuracy of administrative drug claims in the Ontario Drug Benefit database.

Background: Every year in Ontario, the records of over 42 million prescriptions dispensed to persons eligible for Ontario Drug Benefit (ODB) benefits are transmitted to a central database. The ODB database is the second largest database of medications in Canada, containing records on almost half of all medications dispensed in Ontario. There is no information about the reliability of the coding on the ODB drug claims database and, therefore, the objective of this study was to estimate the reliability of coding of the Drug Identification Number, and the date, quantity and duration of the dispensation on claims sent to the ODB.

A randomized controlled trial of a pharmacist consultation program for family physicians and their elderly patients.

Background: Pharmacists can improve patient outcomes in institutional and pharmacy settings, but little is known about their effectiveness as consultants to primary care physicians. We examined whether an intervention by a specially trained pharmacist could reduce the number of daily medication units taken by elderly patients, as well as costs and health care use.

Methods: We conducted a randomized controlled trial in family practices in 24 sites in Ontario.

Recruiting family physicians and patients for a clinical trial: lessons learned.

Background: The randomized controlled trial (RCT) is the most definitive tool for evaluating an intervention. However, methodological deficiencies may limit the internal or external validity of the RCT.

Objective: Our aim was to describe the tactics used and the resources required randomly to select and recruit family physicians (FPs) and their patients aged 65 and older (seniors) for a community-based cluster RCT in primary care.