A Descriptive Study of Systemic Factors that Affect Ambulatory Care Pharmacists

Abstract

Background: Ambulatory care pharmacists support patients and the healthcare team through clinical services such as patient education and comprehensive disease state management. While multiple studies show the impact of ambulatory care pharmacists on others, little research has been done on their own experiences.

Objectives: To learn from ambulatory care pharmacists about their workplace experiences and to identify systemic factors that affect their role as members of interprofessional healthcare teams.

Methods: This exploratory, qualitative study consisted of digitally-recorded, semi-structured interviews with ambulatory care pharmacists. Interviews were transcribed and analyzed inductively and iteratively by a multidisciplinary research team to determine salient themes.

Results: Twenty-one pharmacists (ten in private health systems, eleven in public health systems) participated, 15 of whom described the effects of leadership, metrics, and reimbursement on their roles. While many pharmacists felt supported by leadership, others noted consistent pressure to meet arbitrary quality metrics and frustration with limited reimbursement options. Public health system pharmacists appeared to be more affected by these systemic factors than their private health system counterparts.

Conclusion: Leadership, metrics, and reimbursement are all systemic factors that affect ACPs' workplace experiences, as evinced by participant interviews. More research is necessary to determine how best to support ACPs across health systems to ensure they can continue providing high-quality, accessible patient care.

Keywords: ambulatory care pharmacists; healthcare team; leadership; metrics; reimbursement.