The role of pharmacists in general practice: a realist review

Background The review was carried out review prior to evaluating and to inform our research on the clinical pharmacists in general practices pilot, a world leading initiative to improve health care delivery in England. Around 500 pharmacists are already working in general practice as part of the pilot, launched in July 2015 Objectives The review attempts to explain the how “clinical pharmacists in general practices” is being implemented, what works well, what does not work so well and everything in-between. Methods This realist review was conducted to the RAMESES standards. Studies were identified by searching three databases, Medline, Embase and Scopus. Additional papers were gathered from reference lists, Google searches and via the find similar citations feature. Results A total of 83 papers and articles were initially identified from Medline (19), Embase (31) and Scopus (32). With close reading, the final review consisted of of 43 papers relating to 38 studies. Most of the research was undertaken in the field of pharmacy practice and over half of the studies investigated the perspectives of different stakeholders using questionnaires or qualitative methods. Conclusion The pharmacist in general practices initiative is still at an early stage of implementation, further research and more in-depth findings are still required. However, from this small number of studies, the common barriers and facilitators to the implementation can be identified. The review also lists mechanisms that will be needed to ensure the effective implementation of this initiative.