'We do not seem to engage with dentists': A qualitative study of primary healthcare staff and patients in the North East of England on the role of pharmacists in oral healthcare

Objective: To explore the attitudes towards, and perceptions of, primary care healthcare staff and patients, regarding the role of clinical pharmacists in the provision of oral health advice and collaboration with dentists in general practice.

Design: Interpretivist methodology using qualitative semi-structured interviews and focus groups.

Participants: 22 participants; 10 pharmacists; 3 general practitioners; 2 nurses; 1 practice manager; 6 patients.

Setting: Primary care general medical practices in the North East of England and the University of Sunderland Patient Carer and Public Involvement group.

Methods: One-to-one semi-structured interviews were performed with primary care healthcare staff. An iterative approach using constant comparative analysis facilitated the ongoing enrichment of data; salient themes were identified using Framework Analysis and related back to extant literature. A focus group was held with patients to further explore key themes.

Results: Four salient and inter-related themes emerged: enhanced clinical roles; indicating rapidly changing roles of pharmacists working in general practice, increased responsibility and accountability of pharmacist prescribers and the delivery of advanced clinical services; limited knowledge; indicating basic understanding of appropriate oral health advice, but limited insight and provision of advice to patients with regards to links with systemic diseases and medication; geographical/situational isolation of the dental team; indicating the disparate contexts and challenges of multidisciplinary working in oral health, and patients' attitudes towards dental care; integration of oral health advice; indicating the potential of pharmacists to integrate oral health advice into current roles and to target specific patient groups in practice.

Conclusions: The lack of integration between oral and general healthcare services potentially impacts negatively on patient care, requiring further interprofessional oral health education. The developing role of the pharmacist in general practice represents an opportunity to integrate oral health advice and/or interventions into the management of patients in this setting.