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      Developing consensus on the principles and key actions for collaborative working between general practices and community pharmacies: a modified eDelphi study

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          Abstract

          Objectives

          To develop consensus on the principles and key actions for collaborative working in practice between general practice, community pharmacy and patients and their carers.

          Design

          Three-round modified eDelphi study, starting from an established conceptual model of collaboration between general practitioners (GPs) and community pharmacists.

          Setting

          Community pharmacies and general practices in England, UK.

          Participants

          A panel of 123 experts: 43% from a community pharmacy background; 36% from a GP background; 13% patients, carers or patient representatives and 8% from academic or commissioner backgrounds. Panellist numbers reduced by approximately 30% in rounds 2 and 3.

          Primary and secondary outcome measures

          Consensus between expert panellists, defined as at least 75% agreement.

          Results

          A high level of consensus (>80%) was achieved on all components of a model of collaboration composed of Fundamental Principles of Collaboration and Key Activities for Action, supported by a series of aspirational statements and suggested practical actions. The fundamental principles and key activities are appended by contextual points. The findings indicate that collaboration in practice involves team members other than just GPs and community pharmacists and recognises that patients often want to know how each professional team is involved in their care. This study also provides insights into how collaboration between general practice and community pharmacy settings appears to have shifted during the COVID-19 pandemic, especially through opportunities for virtual collaboration and communication that can transcend the need for close geographical proximity.

          Conclusion

          A consensus-based model of collaboration between general practice teams, community pharmacy teams, and patients and their carers has been developed. It is practically focused, values the patient voice and incorporates general practice and community pharmacy team members. While developed in England, the model is likely to also have applicability to other countries with similar health systems that include general practices and community pharmacies.

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          Most cited references24

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          Defining consensus: a systematic review recommends methodologic criteria for reporting of Delphi studies.

          To investigate how consensus is operationalized in Delphi studies and to explore the role of consensus in determining the results of these studies. Systematic review of a random sample of 100 English language Delphi studies, from two large multidisciplinary databases [ISI Web of Science (Thompson Reuters, New York, NY) and Scopus (Elsevier, Amsterdam, NL)], published between 2000 and 2009. About 98 of the Delphi studies purported to assess consensus, although a definition for consensus was only provided in 72 of the studies (64 a priori). The most common definition for consensus was percent agreement (25 studies), with 75% being the median threshold to define consensus. Although the authors concluded in 86 of the studies that consensus was achieved, consensus was only specified a priori (with a threshold value) in 42 of these studies. Achievement of consensus was related to the decision to stop the Delphi study in only 23 studies, with 70 studies terminating after a specified number of rounds. Although consensus generally is felt to be of primary importance to the Delphi process, definitions of consensus vary widely and are poorly reported. Improved criteria for reporting of methods of Delphi studies are required. Copyright © 2014 Elsevier Inc. All rights reserved.
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            The Delphi Technique: Making Sense of Consensus

            The Delphi technique is a widely used and accepted method for gathering data from respondents within their domain of expertise. The technique is designed as a group communication process which aims to achieve a convergence of opinion on a specific real-world issue. The Delphi process has been used in various fields of study such as program planning, needs assessment, policy determination, and resource utilization to develop a full range of alternatives, explore or expose underlying assumptions, as well as correlate judgments on a topic spanning a wide range of disciplines. The Delphi technique is well suited as a method for consensus-building by using a series of questionnaires delivered using multiple iterations to collect data from a panel of selected subjects. Subject selection, time frames for conducting and completing a study, the possibility of low response rates, and unintentionally guiding feedback from the respondent group are areas which should be considered when designing and implementing a Delphi study. Accessed 68,465 times on https://pareonline.net from August 30, 2007 to December 31, 2019. For downloads from January 1, 2020 forward, please click on the PlumX Metrics link to the right.
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              Guidance on Conducting and REporting DElphi Studies (CREDES) in palliative care: Recommendations based on a methodological systematic review.

              The Delphi technique is widely used for the development of guidance in palliative care, having impact on decisions with relevance for patient care.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2023
                21 September 2023
                : 13
                : 9
                : e074023
                Affiliations
                [1 ]Green Light Pharmacy , London, UK
                [2 ]departmentSchool of Pharmacy , Ringgold_4919University College London , London, UK
                [3 ]departmentSchool of Pharmacy and Bioengineering , Ringgold_158985Keele University , Keele, UK
                [4 ]departmentSchool of Health Sciences , Ringgold_523398The University of Manchester , Manchester, UK
                Author notes
                [Correspondence to ] Mr Simon Harris; simon@ 123456greenlightpharmacy.com
                Author information
                http://orcid.org/0009-0002-9629-6557
                http://orcid.org/0000-0001-7707-2019
                http://orcid.org/0000-0003-3509-2438
                http://orcid.org/0000-0002-0009-1470
                http://orcid.org/0000-0003-0096-251X
                Article
                bmjopen-2023-074023
                10.1136/bmjopen-2023-074023
                10514654
                37734889
                664879c5-4ac0-4a3b-afe4-2bc1a0bde693
                © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 06 April 2023
                : 29 August 2023
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100002121, Pharmacy Research UK;
                Award ID: PRUK-2019-LH3-SH
                Categories
                Communication
                1506
                1684
                Original research
                Custom metadata
                unlocked

                Medicine
                patient-centered care,health policy,quality in health care,primary health care,interprofessional relations

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