"A win-win situation for all": A qualitative exploration of pharmacist and physiotherapist perspectives on a collaborative framework for improving equitable primary care for acute musculoskeletal injuries

Abstract

Background: Musculoskeletal injuries cause significant impairment in social and physical functioning and are a common reason patients access primary care. Many face barriers accessing timely care.

Objectives: To (1) identify whether collaborative practices exist between pharmacists and physiotherapists for managing acute musculoskeletal injuries and (2) assess the acceptability and feasibility of a collaborative framework to improve access in Nova Scotia, Canada.

Design: Qualitative descriptive research using focus groups.

Methods: Focus groups were conducted with pharmacists and physiotherapists. The first round explored current practices and feasibility of collaboration. The second round refined ideas to support framework development. Transcripts were coded deductively based on the APEASE (Acceptability, Practicability, Effectiveness, Affordability, Side effects/safety, Equity) criteria and analyzed inductively to develop themes.

Results: A total of 5 pharmacists and 12 physiotherapists were interviewed. Participants were unaware of any formal collaboration. Participants were eager to collaborate but expressed unfamiliarity with each other's scopes of practice and identified logistical barriers to collaboration. Anticipated benefits identified included: quicker access to care, reduced chronic pain, improved adherence, and fewer emergency department visits, potentially reducing healthcare costs. Participants had concerns about limited rural access and costs of private physiotherapy care.

Conclusion: Key facilitators, barriers, and solutions to collaboration were identified. Concerns were raised around the cost of care, and areas where access may be limited, which need to be addressed to prevent further inequities. The results will guide the development of a pharmacist-physiotherapist collaborative practice framework for musculoskeletal injuries in primary care, which considers ways to improve equitable access to care.

Keywords: Canada; Interprofessional collaboration; Musculoskeletal injury; Pharmacists; Physiotherapists; Primary care.