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PHARMACY PRACTICE

Influential Characteristics of Physician/Pharmacist Collaborative Relationships

Assistant Professor, Department of Pharmacy Practice, School of Pharmacy and Pharmacal Sciences, Purdue University, Indianapolis, IN

Randal P McDonough, MS PharmD

Associate Professor, Division of Clinical and Administrative Pharmacy, College of Pharmacy, University of Iowa, Iowa City, IA

Barry L Carter, PharmD FCCP

Professor and Head, Division of Clinical and Administrative Pharmacy, College of Pharmacy, University of Iowa, and Department of Family Medicine, University of Iowa Roy J and Lucille A Carver College of Medicine

William R Doucette, PhD

Associate Professor, Division of Clinical and Administrative Pharmacy, College of Pharmacy, University of Iowa

Reprints: Alan J Zillich PharmD, Purdue University College of Pharmacy, W7555, Myers Building, 1001 W. 10th St., Indianapolis, IN 46202-2859, fax 317/613-2316, azillich{at}purdue.edu

BACKGROUND: A theoretical model of physician/pharmacist collaborative relationships, driven by 3 groups of relationship characteristics termed participant, context, and exchange, has been developed. There are no studies that have examined the types of characteristics which most influence development of collaborative relationships between physicians and pharmacists.

OBJECTIVE: To test the model and determine which drivers most influence physician/pharmacist collaboration.

METHODS: Data on the relationship drivers and collaborative practice were collected via a mailed survey of a random sample of 1000 primary care physicians in Iowa. Participant variables include demographics; context drivers refer to the practice environment and professional interactions between physicians and pharmacists. Exchange characteristics describe the nature of social exchange and were elicited using scores from 3 domains (relationship initiation, trustworthiness, role specification) of the Physician/Pharmacist Collaboration Instrument (PPCI). Five additional questions asked about the physician's collaborative practice with a pharmacist. Hierarchical linear regression analysis was performed with collaborative practice as the dependent variable and measures of participant, context, and exchange drivers as independent variables.

RESULTS: Three hundred forty usable surveys (34%) were returned. Almost 70% of the respondents were male and aged 45.8 ± 9.9 years (mean ± SD). The majority were family practice physicians (72.1%) in private practice (67.3%). Regression analyses produced an R² = 0.804 (p < 0.001). Significant predictors in the model were internal medicine physicians, professional interaction with a pharmacist, and the 3 domains of exchange drivers from the PPCI (p < 0.05).

CONCLUSIONS: Although participant and context factors influenced physician/pharmacist collaborative relationships, exchange characteristics were the most influential relationship drivers. Role specification, trustworthiness, and relationship initiation were positively associated with physician/pharmacist collaborative practice. Recognition of these drivers may help pharmacists who are developing collaborative working relationships with physicians. But, studies are needed to delineate other factors that may influence physician/pharmacist relationships.

Key Words: communication, coordinated care, physician/pharmacist relationship

Published Online, March 23, 2004. www.theannals.com, DOI 10.1345/aph.1D419

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