ArticleBMC medical education2024
Getting time and building trust: unveiling the systemic, relational, and personal factors influencing clinical pharmacy service implementation in South Africa, a qualitative study.
Article in BMC medical education, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Exchange Characteristics in Interprofessional Collaboration Between Clinical Pharmacists and Physicians: A National Survey.Healthcare (Basel, Switzerland) · 2026Article
- Breaking the safety barrier: Risk factors for unjustified non-acceptance of pharmaceutical interventions in the PICU and their association with mortality.Exploratory research in clinical and social pharmacy · 2026Article
- Learning, adopting, and sustaining the pharmacist-clinician role in clinical practice: a qualitative study among early adopters in the Netherlands.International journal of clinical pharmacy · 2026Article
- Navigating Boundaries: How Pharmacists Develop Their Clinical Identity in a Complex Multidisciplinary Healthcare Setting.Perspectives on medical education · 2025Article
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5 authors.
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Abstract
backgroundWhile multidisciplinary teams with clinical pharmacists improve medication use and outcomes, their integration in South Africa faces limitations. A lack of dedicated positions and healthcare professionals' misunderstanding restrict ward activities and hinder full collaboration, limiting their potential to optimize patient care. This study addresses a gap by exploring how perceived healthcare professionals' understanding of clinical pharmacists' roles impacts their motivation and service implementation. Understanding these dynamics, particularly in resource-constrained settings, is crucial for optimizing integration and healthcare delivery.
methodsAdopting a constructivist approach, this qualitative study was conducted using focus group discussions. Through purposive sampling clinical pharmacists were recruited across South Africa's public healthcare sector. A semi-structured guide based on previous findings explored how the perceived understanding around clinical pharmacy impacts service delivery and work motivation. Transcripts were analyzed using thematic analysis, guided by the Self-Determination Theory framework. Thematic analysis employed an inductive approach, following an initial preliminary analysis of open and selective coding to develop a coding framework.
resultsClinical pharmacists (n = 16) reported various challenges impacting service implementation and motivation. Two main themes were identified: (1) Time: Dedicated ward time is crucial for both the proper implementation of clinical services, as well as the clinical pharmacists' motivation; and (2) Trust: Clinical pharmacists experience a lack of trust amongst healthcare professionals in the value of clinical pharmacy services. The themes illustrated mechanisms at work at three levels: systemic (lack of dedicated positions), inter-relational (healthcare professional's misconceptions), and personal (thwarted autonomy).
conclusionsSystemic challenges, like the absence of official positions present the biggest obstacle, affecting support, scope of practice, and healthcare professional interactions. While systemic changes are crucial for full integration of clinical pharmacists, in resource-constrained settings fostering autonomous motivation is equally important. This study emphasizes the need for a multi-faceted approach, including policy changes, international collaboration, interprofessional education, and interventions to empower clinical pharmacists for proactive service delivery. By addressing these interconnected challenges, healthcare systems can leverage the full potential of clinical pharmacists, ultimately improving healthcare delivery and patient outcomes.
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