Abstract
The sequential embedded mixed-method research consisted of two phases. 1) The qualitative phase is aimed to explore the situation, experience, problems, and barriers of the family pharmacists in primary care cluster. Focus group discussion was conducted in 24 pharmacists working in the primary care unit (PCU) distributed in 7 provinces of the health region, in January 2020 and April 2021. Average period of working experience was 5.6±5.0 years, and eight of them were full-time pharmacists working in the PCU. Findings of content analysis comprised three main themes: pharmacist roles; related factors from policies, colleagues, and the pharmacist; and the resolution of common drug-related problems (DRPs). Four roles of pharmacists were health services at the PCU, home health care, pharmaceutical management, and consumer protection. The patients’ care barriers were a limitation of the health information connection and information access from the PCU. Part-time working in the PCU limited the pharmacist’s roles; however, updated medication knowledge promoted the pharmacists for effective home health care with the team. In addition, local organizations also supported in home health care and the consumer protection. Communication skills, solving DRPs skill and working experience led the pharmacists to providing effective resolutions of DRPs. 2) The prospective, longitudinal quasi-experimental study was performed as quantitative phase. Data collection in 1,471 hypertensive patients for continuously three visits at the PCU in 2020. This aims to examine DRPs, blood pressure, and physician acceptance of pharmacists’ resolution change over the study including factors affecting DRPs resolutions. 379 DRPs were identified and the highest DRP was 164 non-adherence problems. Following the pharmaceutical care, all DRPs and non-adherence were significantly decreased by 3 2 .4% (X2(2)=46.78, p<0.001), and 61.0% (X2(2)=98.60, p<0.001), respectively. Blood pressure was unchanged. Physician acceptance of pharmacists’ resolution were 77.8%, 70.3% and 68.4%, at visit 0, 1 and 2 respectively. Factor affecting non-adherence resolution was physician acceptance of pharmacists’ intervention (rs=0.18, p=0.020). The family pharmacists can reduce DRPs in patients with hypertension. The relevant factor of DRPs resolution was teamwork due to working experience and skills of pharmacists. There should then be increasing experience and related skills through short course training for pharmacists.
