Family physicians’ acceptability, perceived value, and barriers of pharmacist-led medication management in primary care—a theory-based qualitative study

Background Polypharmacy burdens healthcare systems and increases adverse drug events. While pharmacist-led comprehensive medication management (CMM) mitigates these issues globally, its integration into Turkish primary care remains limited. Objective To explore family physicians’ acceptability of pharmacist-led CMM in Türkiye and identify perceived barriers to interprofessional collaboration. Methods A qualitative descriptive study was conducted among primary care family physicians in Istanbul, Türkiye, between June and August 2025. Purposive sampling was utilized to recruit participants with at least 5 years of clinical experience. We collected data through semi-structured online interviews using a guide developed by an interdisciplinary panel and piloted for structural clarity. With NVivo software, transcripts were analyzed using a hybrid thematic analysis approach, combining inductive coding to identify emergent, context-specific themes with deductive mapping to the seven constructs of the Theoretical Framework of Acceptability (TFA). Inter-coder reliability was established through independent parallel coding, and trustworthiness was reinforced via member checking. Reporting adhered to the COREQ checklist. Results Participants ( n = 12) facing severe daily workloads (>74 patients) viewed clinical pharmacists as a crucial safety net. Analysis revealed three core themes: (1) Needs and Opportunities: CMM offers substantial benefits by managing polypharmacy, mitigating physician fatigue, reinforcing patient medication adherence, and reducing overall workload and costs. (2) Concerns and Barriers: Major structural hurdles include physical space constraints in FHCs, data privacy (KVKK) vulnerabilities, and pharmaceutical industry apprehension. (3) Implementation Conditions: Successful integration requires integrated Electronic Health Records (EHR), formalized legal boundaries, and joint interprofessional training. Subgroup analysis indicated that early- to mid-career physicians demonstrated higher implementation readiness, while late-career peers focused more on operational burdens. Conclusion Family physicians demonstrate highly favorable prospective acceptability toward pharmacist-led CMM. Successful real-world integration requires resolving macro-level infrastructural and legal barriers while establishing actionable interprofessional enablers, shared clinical algorithms, and compatible digital workflows.