Exploring international policy approaches to pharmacists’ integration in primary care: a scoping review

Abstract Introduction There has been a lack of research examining policies about pharmacists’ integration in primary care.1 Identifying global policies on pharmacist integration is essential for addressing healthcare workforce shortages and enhancing medication management amid increasing demand and complex patient needs.1 Understanding what promotes integration will enhance pharmacists’ contributions, potentially leading to improved healthcare services worldwide. Aim To identify international policies focusing on pharmacists’ integration in primary care. Methods This review utilised Arksey and O’Malley’s scoping review framework.2 Six electronic databases (PubMed, Medline, Embase, International Pharmaceutical Abstracts, Web of Science, Google Scholar) and country/government-specific websites were searched. Searches of grey literature sources (e.g. Public Library of Science) and hand searching key journals (e.g. Research in Social and Administrative Pharmacy) were conducted. Inclusion criteria were policy publications about pharmacists’ integration in primary care that were published from 2000 onwards (as efforts to integrate pharmacists into primary care began in various countries in 2000) and in English. Exclusion criteria included policy publications unrelated to pharmacists’ integration in primary care, editorials, opinion pieces, and non-English publications. No additional search limits were applied. A thematic synthesis approach was used to synthesise charted data including author, publication date, title, publication type (e.g. strategic reports), country, and policy description to produce a coherent narrative. The review protocol was registered with Figshare. Results Eleven publications were generated from the searches until March 2025. Four were excluded while seven were included in this review based on inclusion criteria. These publications were produced between 2014 and 2024 in the United Kingdom (UK) and the United States (US). The policy publications were developed by governmental (e.g. National Health Service) and professional (e.g. Royal Pharmaceutical Society and the American Society of Health-System Pharmacists) entities. Five themes emerged from synthesis of charted data: (i) medicines optimisation as a core policy (pharmacists play a crucial role in assessing the benefits of ongoing medication, reviewing complex regimens and ensuring continuity of healthcare); (ii) expanding the pharmacist workforce (the two countries have invested in expanding the pharmacist workforce in primary care through recruitment campaigns and professional development); (iii) integration within multidisciplinary and collaborative care (pharmacists are increasingly integrated into multidisciplinary teams to improve care coordination and relieve pressure on primary care providers); (iv) addressing funding, regulation, and technology (the integration of pharmacists in primary care has been facilitated by robust structures such as regulation and technology; however, pharmacists are facing some funding issues); and (v) patient-centredness and impact on health (policy publications highlighted pharmacists as champions of person-centred care, focusing on reducing health issues and improving healthcare access, especially for deprived and rural populations). Conclusion The themes illustrated common priorities between the two countries while also highlighting their divergent approaches to healthcare implementation, specifically the centralised model in the UK and the decentralised model in the US. The application of the Arksey and O’Malley framework2 facilitated the application of a clear methodological process. The limited number of publications and the limited geographical regions from which they were sourced restricts the relevance of findings to international contexts.