Factors affecting task shifting/sharing from physicians to pharmacists in cancer chemotherapy in Japan: A qualitative study

Introduction There is an increasing demand for pharmacists in Japan’s health care system, particularly in cancer chemotherapy. Task shifting/sharing has enabled clinical pharmacists to take a more active role; however, only a few hospitals have adopted this method, suggesting that institutional factors influence its implementation. Therefore, this study aimed to explore the process of implementing task shifting/sharing from physicians to pharmacists and identify the factors of promoting task shifting/sharing in cancer chemotherapy in Japan. Methods We conducted semi-structured focus group interviews with hospital pharmacists in management and nonmanagement positions, between February 2023 and May 2024. All interviews were recorded, transcribed, and independently coded by two researchers. A modified grounded theory approach was used, and data collection continued until theoretical saturation was reached. Results Data saturation was reached after 10 group interviews and two additional interviews were conducted to ensure the comprehensiveness of the data. Five categories were identified: “Barriers,” “Cultural change,” “Workflow redesign,” “Improving professional knowledge and clinical skills,” and “Success of interprofessional collaborative practices.” Revisions to medical fees and government notifications facilitated task shifting/sharing; however, most hospitals encountered significant barriers. Three key factors—“Cultural change,” “Workflow redesign,” and “Improving professional knowledge and clinical skills”—were essential in overcoming challenges and promoting implementation. Conclusions This study highlighted the process of promoting task shifting/sharing in cancer chemotherapy. Most participants perceived that this initiative improved patient outcomes and safety and reduced the workloads of health care professionals. To further promote this initiative, it is crucial to evaluate and publish evidence of its effectiveness. Moreover, sustained support from government bodies and professional organizations is vital for broader implementation.