Facilitators and barriers to the integration and optimization of primary care pharmacy practice in British Columbia.

OBJECTIVES: The Pharmacists in Primary Care Network (PCN) Program integrated Primary Care Clinical Pharmacists (PCCPs) as core members of the interprofessional team (IPT) in PCNs across British Columbia (BC). Our objective was to evaluate stakeholders' perspectives and experiences with integrating PCCPs into team-based care within PCNs in BC describing the facilitators and barriers to pharmacist integration. METHODS: This evaluation utilized qualitative research methods and was informed by Qualitative Description methodology. Participants were invited to participate in individual and focus group interviews and included UBC program team members, health authority pharmacy representatives, PCN administrators, and PCCPs. KEY FINDINGS: Facilitators included: (i) working in a blended model of care; (ii) UBC program team supports and resources; (iii) PCN-related facilitators, (iv) collaboration between stakeholders; and (v) prior practice experience of the PCCP. Barriers included: (i) PCCP's role clarity; (ii) PCCPs integrating into multiple clinics; (iii) resistance to PCCP co-location hindering relationships with IPT members; (iv) prescriber-initiated referral requirement; (v) technology challenges; and (vi) system-related factors. CONCLUSIONS: Broad systemic barriers to the new team-based primary care model in BC challenged PCCP integration along with the evolution and development of the entire IPT. Pharmacist integration was challenged by barriers that stemmed from the lack of understanding of their role and scope and what resources were needed to support them in their role, especially at the PCN level. Understanding the facilitators while addressing the underlying barriers is critical to achieving optimal integration, supporting the satisfaction of PCCPs, and optimizing the provision of team-based patient-centered primary care in BC.