Exploring the pharmacist's role in regional, rural, and remote kidney transplant care: Perspectives of health professionals and transplant recipients

Abstract

Role clarification amongst health professionals is necessary for successful interprofessional collaboration. Despite a demonstrated need for pharmacists in the provision of care to regional, rural, and remote kidney transplant recipients, this role is not well defined. This study explored health professionals' and kidney transplant recipients' perceptions around the role of the pharmacist in the provision of care to kidney transplant recipients from regional, rural, and remote areas of Australia. Semi-structured interviews and focus group discussions were conducted with Australian kidney transplant health professionals and kidney transplant recipients respectively. Transcripts were analysed thematically and deductively coded using a simplified framework of role theory constructs. Participants consisted of a multidisciplinary cross section of transplant health professionals (n = 26) and both deceased and living donor kidney transplant recipients (n = 30). Six role theory constructs were identified from the data with regards to the pharmacist's role: role identity, role ambiguity, role overload, role overqualification, role underqualification, and role insufficiency. Core role expectations centred around provision of ongoing education and support with medication management and supply (role identity), however pharmacists remain underutilised for delivery of medication education (role overqualification). A transdisciplinary model of care was suggested to overcome current shortfalls (role overload, role insufficiency). There was hesitancy around pharmacist-led immunosuppressant monitoring and titration (role ambiguity, role underqualification). Kidney transplant recipients in regional, rural, and remote areas experience unique barriers and challenges associated with medication management, necessitating an increased level of involvement and support from the pharmacist.