Abstract

The effort to enhance interprofessional cooperation in the healthcare environment has earned substantial traction in recent years. Increasing collaborative working between doctors and pharmacists has recently become a high priority within the health system. The study aims to discuss the barrier of interprofessional relations between doctors and pharmacists. The acceptability of the role for pharmacists within the healthcare system has been studied extensively. However, the existing published literature presents an insight into the transitioning of the pharmacist into the professional role and identity of a healthcare professional. The global drive towards improving interprofessional relationships in patient care is considering the increasing influence of medicines and complications of medicines regimens, particularly in chronically ill patients. Collaborative patient management by doctors and pharmacists has the potential to improve patient therapeutic outcomes in the healthcare environment.
This Ph.D. aimed to determine the interprofessional relationships of doctors and pharmacists practising within the hospital sector of Pakistan. In Pakistan, pharmacists face barriers towards their professional role. They struggle for their recognition widely in the health system of Pakistan. The profession lacks significant recognition from other health professions and faces significant barriers to execute their role fully.

A mixed-method approach was used in this study to provide valuable insights into the barriers of interprofessional relations between doctors and pharmacists. Following ethical approvals, the first phase was a cross-sectional survey was undertaken between 1100 participants (doctors and pharmacists) practising within the hospital settings of Pakistan (85% response). Analysis of returned questionnaires identified that more than 70% of the doctors' participants reported interacting with pharmacists at least once daily. The interaction was mainly related to drug availability inquiry. Most doctors expected pharmacists to ensure the safe and appropriate use of medicines to patients. More than 90% of pharmacists mentioned their inadequate training as a reason for not being able to interact with doctors on clinical issues professionally. In-depth qualitative work was undertaken in the second phase, which further explored barriers of interprofessional relations. The interviews were conducted with a purposive sample of 22 participants (10 pharmacists, 12 doctors). Themes highlighting the main research questions have been established. Qualitative interviews provided insight into the processes of interaction between the two professional groups. Doctors in Pakistan consider pharmacists as experts in drug-related information and are receptive to working in collaboration for the betterment of healthcare. However, barriers were hindering the development of this collaboration.
From this study, it can be concluded that pharmacists are perceived as an integral part of the healthcare team. Enhanced Interprofessional collaboration between doctors and pharmacists" can be possible in the future but barriers need to be eliminated for this to be achieved. For the advancement of the healthcare system, it is necessary to utilise the expertise of pharmacists and develop harmony between doctors and pharmacists. This improved collaboration will ultimately benefit the outcome of pharmaceutical care. Pharmacists should be concerned about their professional role and need to be proactive in improving their service delivery. They should move towards collaborative care in order to provide optimal health services. This will pave the way for the expansion of the concept of pharmaceutical care in Pakistan's healthcare system. The project highlighted the barriers of interprofessional relationships between doctors and pharmacists. This research has highlighted that attitudinal barriers of doctors, pharmacist's education, hospital policies towards collaborative work, and trust of doctors towards pharmacists need to be improved in order to accomplish effective collaborative working between doctors and pharmacists.