Open Access Highly Accessed Research article

Pharmacist provision of primary health care: a modified Delphi validation of pharmacists' competencies

Natalie Kennie-Kaulbach1, Barbara Farrell29*, Natalie Ward23, Sharon Johnston2, Ashley Gubbels2, Tewodros Eguale4, Lisa Dolovich5, Derek Jorgenson6, Nancy Waite7 and Nancy Winslade8

Author Affiliations

1 Summerville Family Health Team, Mississauga, Ontario, Canada

2 C.T. Lamont Primary Health Care Research Centre, Élisabeth Bruyère Research Institute, Ottawa, Ontario, Canada

3 Department of Sociology and Anthropology, University of Ottawa, Ottawa, Ontario, Canada

4 Clinical and Health Informatics Research Group, Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada

5 Department of Family Medicine, McMaster University, Centre for Evaluation of Medicines, Hamilton, Ontario, Canada

6 College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada

7 School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada

8 Faculty of Medicine, McGill University and Winslade Consultants Inc, Montreal, Quebec, Canada

9 Scientist, C.T. Lamont Primary Health Care Research Centre, Élisabeth Bruyère Research Institute, 43 Bruyère Street, Ottawa, Ontario K1N 5C8, Canada

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BMC Family Practice 2012, 13:27  doi:10.1186/1471-2296-13-27

Published: 28 March 2012



Pharmacists have expanded their roles and responsibilities as a result of primary health care reform. There is currently no consensus on the core competencies for pharmacists working in these evolving practices. The aim of this study was to develop and validate competencies for pharmacists' effective performance in these roles, and in so doing, document the perceived contribution of pharmacists providing collaborative primary health care services.


Using a modified Delphi process including assessing perception of the frequency and criticality of performing tasks, we validated competencies important to primary health care pharmacists practising across Canada.


Ten key informants contributed to competency drafting; thirty-three expert pharmacists replied to a second round survey. The final primary health care pharmacist competencies consisted of 34 elements and 153 sub-elements organized in seven CanMeds-based domains. Highest importance rankings were allocated to the domains of care provider and professional, followed by communicator and collaborator, with the lower importance rankings relatively equally distributed across the manager, advocate and scholar domains.


Expert pharmacists working in primary health care estimated their most important responsibilities to be related to direct patient care. Competencies that underlie and are required for successful fulfillment of these patient care responsibilities, such as those related to communication, collaboration and professionalism were also highly ranked. These ranked competencies can be used to help pharmacists understand their potential roles in these evolving practices, to help other health care professionals learn about pharmacists' contributions to primary health care, to establish standards and performance indicators, and to prioritize supports and education to maximize effectiveness in this role.

Primary health care; Pharmacy; Pharmacists; Competencies; Scope of practice