Inter-professional collaboration and associated factors among pharmacists and physicians at University of Gondar Specialized Hospital

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It involves communication and decision-making. Inter-professional collaboration between healthcare professionals improves drug safety, patient outcome and minimizes healthcare costs. In Ethiopia, the extent of collaboration remains underexplored. This study evaluates the degree of collaboration and factors affecting collaboration between physicians and pharmacists within University of Gondar Comprehensive Specialized Hospital. Methods A Hospital-based cross-sectional study was conducted from September to October 2025 among physicians and pharmacists working at the University of Gondar Comprehensive Specialized Referral Hospital. Data were collected using a standardized questionnaire based on the Physician–Pharmacist Collaboration Index (PPCI). The PPCI assesses three domains—trustworthiness, role specification, and relationship initiation. Data were analyzed using SPSS version 26, employing descriptive statistics and multiple linear regressions to identify factors associated with collaborative care. Results A total of 161 professionals (96 physicians and 65 pharmacists) participated. The mean PPCI score was 72.6 ± 9.6 for pharmacists and 71.0 ± 3.2 for physicians, indicating moderate collaboration. Pharmacists scored higher than physicians in relationship initiation (11.78 ± 2.3 vs. 9.87 ± 2.5; p ≤ 0.05) and collaborative care (26.6 ± 3.7 vs. 24.2 ± 3.4; p ≤ 0.05). Regression analysis showed that pharmacists working in inpatient (p = 0.04) and ART pharmacies (p = 0.02) reported higher collaboration scores compared to those in outpatient settings. Among collaboration domains, role specification (p = 0.04) and relationship initiation (p = 0.01) significantly predicted collaborative care among pharmacists. For physicians, collaboration was significantly associated with working in the internal medicine ward (p = 0.02), trustworthiness (p = 0.04), and relationship initiation (p = 0.02). Demographic factors such as age, sex, and years of experience were not significant predictors (p > 0.05). Conclusion The study showed moderate level of collaboration between physicians and pharmacists. Role specification, relationship initiation, and professional trust were the major factor that affects collaboration, while demographic factors had less effect. Strengthening interprofessional communication, clarifying professional roles, and increase trust-based relationships are important to increase collaboration. Interprofessional collaboration Trustworthiness Role specification Relationship initiation Ethiopia BACKGROUND Inter-professional collaboration (IPC) occurs when more than two professions work together for common goals and to solve a variety of problems. IPC in healthcare is a cooperative process from different disciplines for joint decisions with shared responsibility to achieve better patient-centered therapy( 1 ). IPC is a strategy to improve the efficiency of healthcare systems and health outcomes. The World Health Organization (WHO) defines IPC as a collaborative practice in health care that occurs when different health care professional provides comprehensive care for a patient( 2 ). Effective IPC reduce medical errors and increase medication safety, ensures appropriate drug interventions, and improve treatment outcomes ( 3 ). In Hospital settings, health professional participated in drug management are nurses, physicians, pharmacists, and patients. IPC involves coordinated efforts among health professionals to optimize patient outcomes and improve healthcare efficiency ( 3 , 4 ). IPC involves open communication, information sharing, and joint decision-making. A better IPC between pharmacists and physicians also improving treatment by facilitating the exchange of data about patients, solving drug treatment problems, and develop conductive work condition( 5 ). One of the ways to improve drug treatment collaboration is communication and joint decision-making between physician and pharmacists ( 6 ). Open communication is important to share patient data. A study done collaboration at Asmara hospital, Eritrea, showed that 88% of physicians accepted the professionalism of pharmacists; 60% of physicians did not agree that pharmacists used their potential in patient care, but 96% of physicians strongly agreed that they accept pharmacist recommendations for patient ( 7 ). Organizational structure, available facilities, and working setting can affect Inter-professional collaboration. The exchange characteristics consist of the nature of the social exchange between the two parties, including communication, trust, and role specification( 8 ). A study undertaken in Iraqi showed that the initiation relationship, trust and specific roles of pharmacists and doctors were dominant factors affects collaboration ( 9 ). A study done in Canada showed that pharmacist-physician collaboration significantly improves chronic disease management, especially in hypertension and diabetes care.( 10 ) A study conducted in Addis Ababa revealed that healthcare professionals acknowledged the importance of collaboration, actual implementation was low due to unclear role definitions, workload, and lack of training on collaborative practice with the mean PPCI score of 60.4 and 62 for physicians and pharmacist respectively( 11 ). Similarly, another study in the Somali National Regional State, Ethiopia found that the collaboration between the physicians and pharmacists was sub-optimal and the exchange variables had a significant effect on their collaboration( 12 ). Several factors influence the extent of IPC, including institutional policies, professional training, workplace culture, and individual attitudes. The level of education during undergraduate training significantly affects the willingness of health professionals to collaborate. Despite growing recognition of the importance of IPC, study regarding status of collaboration between pharmacists and other health professionals, particularly in low-resource settings, remains limited( 13 ). Understanding the factors that affect collaboration is important to enhance collaboration in healthcare systems. In Ethiopia, IPC is recognized as crucial to improve health service delivery; pharmacists are still underutilized in clinical decision-making processes ( 14 , 15 ). Therefore, this study assessed the extent of IPC between pharmacist and physician and identified factors that affect collaboration. METHODS Study Design, Participants and settings The study was undertaken in a hospital-based descriptive cross-sectional study by using a questionnaire. It was conducted at the University of Gondar Comprehensive Specialized Referral Hospital from September to October 2025. The University Of Gondar Comprehensive Specialized Referral Hospital is situated in Gondar town, which is about 748 km far from Addis Ababa, the capital of Ethiopia. It provides health services to over seven million people living in the northwestern region of the country. The Hospital employed about 2,331 staff members, including 1,098 health professionals and 217 physicians. The Hospital serves as a teaching facility affiliated with the University of Gondar, providing practical training in diverse departments such as Internal Medicine, Surgery, Pediatrics, Obstetrics and Gynecology, and Public Health. The occupancy of the hospitals ranged from 50 to 400 beds with different specialties such as gynecology, surgery, internal medicine and pediatrics. Healthcare institutions usually encompass outpatient clinics, pharmacy and laboratory and might have minor surgery room. The paper surveys were handed to a convenience sample of 96 physicians and 85 pharmacists who they met in at University of Gondar Comprehensive Specialized Referral Hospital. The Hospital contains pharmacists and physicians working within same settings and having opportunity to collaborate. Source and Study Population The source and study population comprised all health professionals working in Gondar University Comprehensive Specialized Referral Hospital including pharmacist, and physicians working at the hospital for at least six months. Exclusion criteria Pharmacist and physician professionals working in Gondar University Comprehensive Specialized Referral Hospital who did not directly involve patients care, such as managers and directors were excluded. We also excluded participants who had less than six months of working experience or unable to provide informed consent. Inclusion Criteria Pharmacist and physician working at University of Gondar Comprehensive Specialized Referral Hospital, who are willing to participate in the study and have at least six months of experience. Certain medical practitioners who were unavailable for data collection or who were on maternity or annual leave were not included in the study. Dependent and Independent Variables Extent of IPC was measured through questionnaires assessing the extent of collaboration between Pharmacist and physician. The independent variables of the study include socio demographic characteristics such as age, gender, profession and experience duration. Data Collection technique and instruments A Standardized questionnaire was used to collect data from pharmacists and physicians, utilizing the kobo collection tool with three trained data collectors. The data collection tool has two parts: one for physicians and another for pharmacists. Each pharmacist was asked to answer questions about her/his collaboration with the physician with whom she/he was worked recently, and each physician was asked about her/his collaboration with the pharmacist with whom she/he was worked recently as well. A McDonough and Doucette model was used to assess the status of inter-professional collaboration and factors affecting physicians’ and pharmacists’ collaboration during treatment of their common patients. The model includes independent variables that affect physician-pharmacist collaboration, including demographics, professional experience, and exchange characteristics including trustworthiness, role specification, and relationship initiation. The pharmacist-physician collaboration instrument (PPCI) has 14 questions, with scores ranging from 14 to 92; higher scores show better collaboration. The PPCI evaluates three domains of collaborative relationships: trustworthiness, role specification, and relationship initiation, which are rated on a 7-point Likert scale from 1 (very strongly disagree) to 7 (very strongly agree). The scoring ranges are 6–42 for trustworthiness (6 questions), 5–35 for role specification (5 questions), and 3–21 for relationship initiation (3 questions). Additionally, demographic variables such as age, gender, experience, and practice area are collected, as these may affect collaboration. Data Quality Assurance To ensure data quality, we clearly elaborated about the research and questioners administer to the participants. The collected data was thoroughly checked for completeness and consistency by principal investigators. Two day training was given for data collector and supervisor. The training covered data collection processes with Kobo tool and study objectives. It also covers timely data collecting and submission of collected data. The supervisors check Completeness of each questionnaire during data collection process. Data Analysis Data collected using kobo toolbox was then transferred to SPSS software version 26 for analysis to identify trends and correlations. The analysis techniques used include descriptive statistics and multiple logistic regressions. Ethical Considerations A formal letter of ethical approval was obtained from the Ethical Review Board of the School of Pharmacy, College of Medicine and Health Science, University of Gondar, with protocol number SOP 087/10/05/2025. This study done following the principles outlined in the Declaration of Helsinki, ensuring ethical standards were met. The confidentiality of the study participants was kept by assigning unique identifiers during data collection. Oral informed consent was obtained from all study participants, ensuring that their participation is voluntary. The name and address of the participants was not recorded to ensure their privacy. Participants were allowed to discontinue the research at any time. RESULT Respondent Characteristics There were 161 pharmacists and Physician participated. The participants ranged in ages ( 25 – 30 ) ages 67 (37.1%), and from 31–40 years cover 86 (57.1%). The majority of participants were male (98, 52%), and had working experience of 5–10 years (164, 42.9%). The mean age of the pharmacists was younger (30.35 years old) than that of the physicians (37.99 years old). Thus, the physicians had a longer period of practice (11.32 years) than pharmacists (5.45 years). Most pharmacists were male (67.7%), while majority of physicians were female (56.3%) as presented in Table 1 . Table 1 Socio-demographic Characteristics Individual characteristics Pharmacist Physician Category Frequency (%) Frequency (%) Sex Male 44 (67.7%) 54(56.3) Female 21 (32.3%) 42 (43.7%) Age 25–30 24 (37.1%) 43 (45%) 31–40 37 (57.1%) 49 (51.1%) > 41 4 (5.8%) 3 (5.8%) Years of experience ≤ 5 28 (43.1%) 69 (71.9%) > 5 31 (46.9%) 27 (28.2%) Practice area of pharmacist OPD pharmacy 21(32.3) Emergency pharmacy 9(13.8) Inpatient pharmacy 22(33.8) ART pharmacy 13( 20 ) Practice area of physician Internal medicine ward 29 (30.2) Pediatric ward 17(17.7) Surgical ward 13(13.5) OPD ward 17(17.7) Emergency Ward 8(8.3) Gyna and Obs ward. 12(12.5) Keys: All data are N (%) or mean ± SD Team-based Physician–Pharmacist Collaboration The multi-item variables showed good internal consistency reliability (Cronbach’s alpha (α) values ≥ 0.8) for both pharmacists and physicians as presented in Table. There was no significant difference between the mean scores of physicians and pharmacists for trustworthiness and role specification domains. The Mean trustworthiness score for physician was (31.92 ± 2.3 out of 42) and for role specification (27.33 ± 4.1 out of 35) whereas the mean pharmacists trustworthiness (32.31 ± 3.4 out of 42) and role specification (28.53 ± 4.1 out of 35) as detailed in Table 4 . However, Pharmacists had higher scores in relationship initiation (11.78 ± 2.3 out of 21) and collaborative care (26.6 ± 3.7 out of 35) than physicians with score of 9.87 ± 2.5 out of 21 and 19.78 ± 3.6 out of 35, respectively. Pharmacists were more likely to initiate relationships and collaborate than physicians (p-value ≤ 0.05). However, both professionals had less likelihood to collaborate according to the 7-point likert scale as shown in Table 2 . Table 2 Pharmacist and physician-rated Physician-Pharmacist Collaboration Index (PPCI) domain scores Domains (Range) Pharmacist- rated Physician-rated PPCI score (mean ± SD) Cronbach’s alpha PPCI score (mean ± SD) Cronbach’s alpha p-value Trustworthiness (6–42) 32.31 ± 3.4 0.74 31.92 ± 2.3 0.71 0.87 Role specification (5–35) 28.53 ± 4.1 0.73 27.33 ± 4.1 0.78 0.83 Relationship initiation ( 3 – 21 ) 11.78 ± 2.3 0.69 11.78 ± 2.6 0.73 0.5 Total score (14–92) 72.62 + 9.6 0.72 71.03 + 3.2 0.76 Collaborative care (5–35) 26.6 ± 3.7 0.77 24.2 ± 3.4 0.74 0.1 The multiple linear regression analysis evaluated using different independent variables, including demographic characteristics, area of practice, and dimensions of interprofessional collaboration. The results showed that sex, age category, and years of experience were not significant (p > 0.05), indicating these factors did not affect the interprofessional collaboration. Regarding the area of practice, pharmacists working in inpatient and antiretroviral therapy pharmacies significantly outcome scores compared to outpatient department (p = 0.03; and p = 0.04, respectively). This result showed that professionals in these settings may have better collaborative experiences with measured outcome. Among the domains of collaboration, trustworthiness showed a negative but non-significant association (p = 0.29). However, both role specification (p = 0.01) and relationship initiation ( p = 0.00) were significant predictors, implying that clear role definition and proactive relationship-building among professionals contribute positively to the outcome as presented in Table 3 . Table 3 multiple regression analysis of factors affecting the collaborative care for the pharmacists Independent variables Beta coefficients p-value Sex 0.53 0.56 Age category 25-30 a -0.58 0.61 31-40 a -0.68 0.63 ≥ 41 a -2.62 0.24 Years of experience ≤ 5 0.23 0.79 Area of practice OPD pharmacy b -0.63 0.74 Emergency pharmacy b 0.81 0.59 Inpatient pharmacy b 3.76 0.04* ART pharmacy b 3.14 0.02* Trustworthiness -0.14 0.33 Role specification 0.34 0.04* Relationship initiation 0.54 0.01* Keys: a Age ≥ 41 is the reference, physicians with > 5 years of experience, female is a reference b Drug store is the reference, *p < 0.05 The multiple linear regression analysis evaluated the factors that affect collaboration among physicians. The result showed that sex had negative but non-significant association with collaboration (p = 0.08), demonstrating that male and female physicians did not have significant difference in collaboration. Regarding age, physicians aged 25–30 years (p = 0.61) and 31–40 years (p = 0.3) showed no significant differences compared to those aged above 41 years. Similarly, years of experience (≤ 5 years) showed negative but non-significant effect (p = 0.77), implying that experience did not significantly affect physicians’ collaboration. With respect to the area of practice, physicians in the internal medicine ward showed a significant positive relationship with collaboration (p = 0.01), indicating that those in internal ward showed significant collaboration compared to the general ward. In contrast, physicians in pediatric ward, surgical ward, outpatient department, and emergency ward did not show significant associations with collaboration. Among domain of interprofessional collaboration, trustworthiness (p = 0.03) and relationship initiation (p = 0.01) were significant positive predictors of collaborative care among physicians as presented in Table 4 . This shows that physicians who demonstrated higher levels of trust and proactively initiated professional relationships were more likely involve in collaboration. However, role specification (p = 0.5) did not have significant effect, suggesting that defined roles alone may not be sufficient to enhance collaboration. Table 4 Multiple regression analysis of factors affecting collaboration for physicians Independent variables Beta coefficients p-value Sex -1.63 0.08 Age category in years 25-30 a -1.14 0.62 30-40 a -1.8 0.2 45 a -4.14 0.04* Years of experience in years (≤ 5) b -0.39 0.63 Area of practice Internal medicine ward c 3.73 0.02* Pediatric ward c 0.38 0.73 Surgical ward c 0.19 0.78 OPD ward c 0.52 0.63 Emergency Ward c -1.31 0.34 Trustworthiness 0.18 0.04* Role specification -0.06 0.71 Relationship initiation 0.74 0.02* Keys : a Age ≥ 41 is the reference group, female is the reference, general ward is the reference for practicing area, *p < 0.05 DISCUSSION Effective collaboration between physicians and pharmacists recognized as a major factor to improve patient outcomes, enhance medication safety, and increase healthcare efficiency( 16 ). The current study assessed the extent of interprofessional collaboration between physicians and pharmacists at the University of Gondar Comprehensive Specialized Hospital using the validated Physician–Pharmacist Collaboration Index (PPCI). This study showed that Pharmacists who worked in close collaboration with physicians showed significantly higher pharmacist-rated PPCI scores ( mean 72.62 + 9.6), suggesting that pharmacists perceived strong professional relationships and active participation in patient care. This result showed that physicians viewed pharmacists as credible, trustworthy partners in patient management, consistent with earlier studies emphasizing that mutual trust, respect, and recognition of professional expertise are key factor for collaboration( 17 ). The mean PPCI scores in this study were comparable to those reported by Snyder et al. (2010)( 16 ), who found a total PPCI score of 89.8 ± 4.6 among pharmacist–physician pairs, suggesting a moderate-to-strong collaboration. Although collaboration levels were positive, results also revealed that the relationships between physicians and pharmacists require continued effort and support. As reported in previous studies, collaboration flourish when built upon shared goals, role clarity, and sustained communication ( 18 , 19 ). This study reinforces that these relational and organizational factors are more important than demographic characteristics in predicting collaborative practice. Indeed, in this study, demographic factors such as sex, age, and years of experience were not significantly associated with collaboration among both pharmacists and physicians. This result aligns with previous studies showing that demographic factors alone may not determine collaboration ( 16 , 20 ). The lack of significance suggests that collaboration may affected by professional, organizational, and relational factors than by personal attributes. However, the mean age difference between pharmacists (30.35 years) and physicians (37.99 years) implies that physicians had longer professional exposure, which may contribute to different perceptions of collaboration. Interestingly, physicians aged 36–45 years showed significant negative association with collaborative care, indicating reduced collaboration. This result may show role fatigue or hierarchical professional culture, as mid-career physicians may prioritize autonomy over team decision-making ( 17 , 19 ). Similar results were reported in previous studies, where age and experience correlate inversely with openness to interprofessional collaboration ( 21 ). The area of professional practice significantly influenced collaborative engagement. Pharmacists working in inpatient and ART (antiretroviral therapy) pharmacies had higher collaboration scores compared to those in OPD or emergency pharmacies. These settings need continuous interaction between physicians and pharmacists to optimize therapy, especially in ART pharmacy where polypharmacy and adherence monitoring are critical( 22 , 23 ). Similarly, physicians in the internal medicine ward reported stronger collaboration than those in other wards. Internal medicine usually needs multidisciplinary input for chronic disease treatment, thereby fostering structured communication and teamwork ( 20 , 23 ). In contrast, lower collaboration scores found in the surgical and emergency wards might be related to high patient turnover, which may limit interprofessional discussion ( 18 ). These results proposed that institutional policies facilitate collaboration and communication systems across all departments are important to increase teamwork. Among the dimensions of collaboration, relationship initiation and role specification emerged as significant positive predictors of collaborative care among pharmacists, whereas trustworthiness and relationship initiation were significant among physicians. These findings reinforce the multidimensional nature of interprofessional collaboration and the importance of interpersonal and organizational clarity in fostering teamwork. The strong predictive value of relationship initiation highlights that proactive communication and willingness to engage are key facilitators of collaboration( 20 ). Pharmacists’ higher scores in this domain indicate their active efforts to establish professional relationships, likely reflecting the growing recognition of pharmacists’ clinical roles within multidisciplinary teams ( 24 , 25 ). The physician responses showed that relationship initiation had a significant positive relationship with collaboration. Physicians may be better positioned to initiate interprofessional relationships due to their decision-making authority and clinical leadership roles ( 26 ). In several healthcare settings, physicians possess greater institutional power in treatment decision-making, which may affect how collaboration initiates and develops. As such, when physicians initiate professional relationships, the collaboration process tends to progress more rapidly, reflecting a hierarchical but cooperative dynamic ( 17 ). Physicians may also expect the pharmacists to introduce and offer their collaboration in drug selection. However, most physicians do not have regular visits to hospital pharmacy to be updated with new medications and that may have a chance to build physician–pharmacist relationships. The presence of pharmacists at daily morning rounds, when medication selection done might facilitate collaboration. Thus, physicians who had pharmacists help initiate the relationship were able to move into the more collaborative stage ( 25 , 27 ). Role specification allows each professional to clearly understand and respect the responsibilities of the other. For instance, while physicians prescribe medications, pharmacists contribute via medication review, error detection, and provide drug-related infomation—creating a complementary relationship that enhances patient safety. The positive effect of role specification among pharmacists shows that clarity in responsibilities enhances mutual respect and efficiency. Clear role understanding reduces professional ambiguity and minimizes role conflict, thereby supporting smoother coordination of patient care( 28 ). Conversely, the lack of significance of role specification among physicians may suggest that hierarchical structures or physician-dominated models of care persist, potentially undermining shared responsibility( 20 ). Trustworthiness was positively associated with collaboration among pharmacists and physicians. Mutual trust forms the foundation of effective team functioning( 29 ). Mutual trust encourages open communication, shared decision-making, and reduces professional conflicts which affect collaboration ( 21 ). A study done in the UK also emphasized that trustworthiness is foundational element to foster the exchange between pharmacist and physician. Both professionals work to acquire mutual trust. The best way to increase physician’s trust to pharmacist is by showing competence via evidence-based clinical recommendations that improve patient safety. When mutual trust is built, the collaboration level will improve. Studies have similarly shown that frequent contact and shared decision-making environments contribute increase collaborative trust ( 25 ),( 30 ). However, when such opportunities are limited, as in outpatient or emergency settings, professional collaboration may be hindered. However, other studies reported, some physicians may resist pharmacists’ input due to traditional role perceptions or professional autonomy, suggesting that institutional and cultural change is also necessary ( 21 ). This study also showed that collaboration was affected by professional practice setting. The management barriers can be reduced by working with similar hospital setting. We supposed that physicians and pharmacists working within same hospital would have more chance to collaborate as they have face-to-face contact and less administrative barriers. In particular, pharmacists working in inpatient and antiretroviral therapy pharmacies showed higher collaboration scores, likely due to the complexity of treatments requiring coordinated input from multiple professionals. Similarly, physicians working in internal medicine wards—where multidisciplinary approaches are common—showed significantly greater collaboration. These observations align with the view that proximity and structured teamwork environments enhance interprofessional relationships( 20 ). Strengths and Limitations The present study provides valuable insight into physician–pharmacist collaboration at University of Gondar Comprehensive Specialized Referral Hospital a setting where such studies are limited. It is one of the few studies to use the PPCI tool to assess interprofessional collaboration in an inpatient environment. However, the study has certain limitations. First, the data were collected from a single institution (University of Gondar Comprehensive Specialized Hospital), limiting generalizability to other healthcare settings. Second, the cross-sectional design prevents causal inference. Longitudinal studies would be beneficial to assess how collaboration evolves over time and how interventions such as joint rounds or interprofessional training influence PPCI scores. Conclusion In conclusion, IPC between pharmacists and physicians at the University of Gondar Comprehensive Specialized Hospital was moderate but promising. While pharmacists were perceived as trustworthy and engaged, collaboration remained suboptimal due to factors such as communication barriers, and limited structured opportunities for interaction. Relationship initiation, trustworthiness, and role clarity were key facilitators of successful collaboration. To strengthen IPC, the Hospital management should promote joint clinical rounds, interprofessional education, and structured communication channels that build mutual trust and professional respect. Addressing these factors is crucial for developing a sustainable collaborative culture that ultimately enhances patient safety and clinical outcomes. Abbreviations IPC; interprofessional collaboration, PPCI: Physician–Pharmacist Collaboration Index Declarations Ethics approval and consent to participate The University of Gondar review board sought ethical clearance from the ethical review committee of the school of pharmacy. Oral informed consent was obtained from each study participant after the purpose of the study was explained. Consent for publication Not Applicable Availability of data and materials All the data generated during this study included within the article. Competing interests There weren't any conflicting interests. Funding Not funded Authors' contributions "T.A, and A.B. participated in Conceptualization, Data analysis, Investigation, Methodology, Supervision, Validation, Visualization, Writing - original draft. T .M, S.A and A.B contributed in data analysis, writing - review & editing the manuscript. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7954442","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":538667676,"identity":"a69c5a85-e4e2-4579-8cbe-fa0305b62188","order_by":0,"name":"Tafere Mulaw Belete","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAw0lEQVRIiWNgGAWjYLCCCiDmZ2BgI1Y9MwPDGSAl2UCyFoMDxGrRnZF/8MOBintyxjeSnz34UMEgzy92AL8WsxvJzBIHzhQbm91IMzeccYbBcObsBIJaGKQ/tiUkbruRYCbN28aQYHCbsBbmHwf/JdRvnpH+jWgtbBIHGxISDCRyiLXlzGMziwPHEoDeeFMmOeOMBBF+OZ74+MaBmgR5/vb0bRIfKmzk+aUJaEEAAbBKCWKVgwD/AVJUj4JRMApGwUgCAGYrRYmo7zgdAAAAAElFTkSuQmCC","orcid":"","institution":"University of Gondar","correspondingAuthor":true,"prefix":"","firstName":"Tafere","middleName":"Mulaw","lastName":"Belete","suffix":""},{"id":538667678,"identity":"206a438d-18c3-47a6-8e7f-cf3b5249e412","order_by":1,"name":"Etsub Tadlo","email":"","orcid":"","institution":"University of Gondar","correspondingAuthor":false,"prefix":"","firstName":"Etsub","middleName":"","lastName":"Tadlo","suffix":""},{"id":538667679,"identity":"45018a9a-9515-465f-803c-17afabc68be9","order_by":2,"name":"Mathias Bekele","email":"","orcid":"","institution":"University of Gondar","correspondingAuthor":false,"prefix":"","firstName":"Mathias","middleName":"","lastName":"Bekele","suffix":""},{"id":538667681,"identity":"87c702a7-91d5-47cf-908f-2e9a76c1956f","order_by":3,"name":"Solomon Asmamaw Tadesse","email":"","orcid":"","institution":"University of Gondar","correspondingAuthor":false,"prefix":"","firstName":"Solomon","middleName":"Asmamaw","lastName":"Tadesse","suffix":""},{"id":538667682,"identity":"0eb93a0d-08e2-4407-9f2b-52fe5aaa094d","order_by":4,"name":"Alemante Tafese Beyna","email":"","orcid":"","institution":"University of Gondar","correspondingAuthor":false,"prefix":"","firstName":"Alemante","middleName":"Tafese","lastName":"Beyna","suffix":""},{"id":538667683,"identity":"1e2d4f30-4444-443a-9994-f02eaf89d5bc","order_by":5,"name":"Habtamu Semagne Ayele","email":"","orcid":"","institution":"University of 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10:01:59","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":930969,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7954442/v1/2f4853f3-d114-48f6-8d6b-4528a62fb32b.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Inter-professional collaboration and associated factors among pharmacists and physicians at University of Gondar Specialized Hospital ","fulltext":[{"header":"BACKGROUND","content":"\u003cp\u003eInter-professional collaboration (IPC) occurs when more than two professions work together for common goals and to solve a variety of problems. IPC in healthcare is a cooperative process from different disciplines for joint decisions with shared responsibility to achieve better patient-centered therapy(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). IPC is a strategy to improve the efficiency of healthcare systems and health outcomes. The World Health Organization (WHO) defines IPC as a collaborative practice in health care that occurs when different health care professional provides comprehensive care for a patient(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Effective IPC reduce medical errors and increase medication safety, ensures appropriate drug interventions, and improve treatment outcomes (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). In Hospital settings, health professional participated in drug management are nurses, physicians, pharmacists, and patients. IPC involves coordinated efforts among health professionals to optimize patient outcomes and improve healthcare efficiency (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIPC involves open communication, information sharing, and joint decision-making. A better IPC between pharmacists and physicians also improving treatment by facilitating the exchange of data about patients, solving drug treatment problems, and develop conductive work condition(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). One of the ways to improve drug treatment collaboration is communication and joint decision-making between physician and pharmacists (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Open communication is important to share patient data. A study done collaboration at Asmara hospital, Eritrea, showed that 88% of physicians accepted the professionalism of pharmacists; 60% of physicians did not agree that pharmacists used their potential in patient care, but 96% of physicians strongly agreed that they accept pharmacist recommendations for patient (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Organizational structure, available facilities, and working setting can affect Inter-professional collaboration. The exchange characteristics consist of the nature of the social exchange between the two parties, including communication, trust, and role specification(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eA study undertaken in Iraqi showed that the initiation relationship, trust and specific roles of pharmacists and doctors were dominant factors affects collaboration (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). A study done in Canada showed that pharmacist-physician collaboration significantly improves chronic disease management, especially in hypertension and diabetes care.(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e) A study conducted in Addis Ababa revealed that healthcare professionals acknowledged the importance of collaboration, actual implementation was low due to unclear role definitions, workload, and lack of training on collaborative practice with the mean PPCI score of 60.4 and 62 for physicians and pharmacist respectively(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Similarly, another study in the Somali National Regional State, Ethiopia found that the collaboration between the physicians and pharmacists was sub-optimal and the exchange variables had a significant effect on their collaboration(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eSeveral factors influence the extent of IPC, including institutional policies, professional training, workplace culture, and individual attitudes. The level of education during undergraduate training significantly affects the willingness of health professionals to collaborate. Despite growing recognition of the importance of IPC, study regarding status of collaboration between pharmacists and other health professionals, particularly in low-resource settings, remains limited(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Understanding the factors that affect collaboration is important to enhance collaboration in healthcare systems. In Ethiopia, IPC is recognized as crucial to improve health service delivery; pharmacists are still underutilized in clinical decision-making processes (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Therefore, this study assessed the extent of IPC between pharmacist and physician and identified factors that affect collaboration.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e\u003cb\u003eStudy Design, Participants and settings\u003c/b\u003e\u003c/h2\u003e\u003cp\u003eThe study was undertaken in a hospital-based descriptive cross-sectional study by using a questionnaire. It was conducted at the University of Gondar Comprehensive Specialized Referral Hospital from September to October 2025. The University Of Gondar Comprehensive Specialized Referral Hospital is situated in Gondar town, which is about 748 km far from Addis Ababa, the capital of Ethiopia. It provides health services to over seven million people living in the northwestern region of the country. The Hospital employed about 2,331 staff members, including 1,098 health professionals and 217 physicians. The Hospital serves as a teaching facility affiliated with the University of Gondar, providing practical training in diverse departments such as Internal Medicine, Surgery, Pediatrics, Obstetrics and Gynecology, and Public Health. The occupancy of the hospitals ranged from 50 to 400 beds with different specialties such as gynecology, surgery, internal medicine and pediatrics. Healthcare institutions usually encompass outpatient clinics, pharmacy and laboratory and might have minor surgery room. The paper surveys were handed to a convenience sample of 96 physicians and 85 pharmacists who they met in at University of Gondar Comprehensive Specialized Referral Hospital. The Hospital contains pharmacists and physicians working within same settings and having opportunity to collaborate.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eSource and Study Population\u003c/h3\u003e\n\u003cp\u003eThe source and study population comprised all health professionals working in Gondar University Comprehensive Specialized Referral Hospital including pharmacist, and physicians working at the hospital for at least six months.\u003c/p\u003e\n\u003ch3\u003eExclusion criteria\u003c/h3\u003e\n\u003cp\u003ePharmacist and physician professionals working in Gondar University Comprehensive Specialized Referral Hospital who did not directly involve patients care, such as managers and directors were excluded. We also excluded participants who had less than six months of working experience or unable to provide informed consent.\u003c/p\u003e\n\u003ch3\u003eInclusion Criteria\u003c/h3\u003e\n\u003cp\u003ePharmacist and physician working at University of Gondar Comprehensive Specialized Referral Hospital, who are willing to participate in the study and have at least six months of experience. Certain medical practitioners who were unavailable for data collection or who were on maternity or annual leave were not included in the study.\u003c/p\u003e\n\u003ch3\u003eDependent and Independent Variables\u003c/h3\u003e\n\u003cp\u003eExtent of IPC was measured through questionnaires assessing the extent of collaboration between Pharmacist and physician. The independent variables of the study include socio demographic characteristics such as age, gender, profession and experience duration.\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eData Collection technique and instruments\u003c/h2\u003e\u003cp\u003eA Standardized questionnaire was used to collect data from pharmacists and physicians, utilizing the kobo collection tool with three trained data collectors. The data collection tool has two parts: one for physicians and another for pharmacists. Each pharmacist was asked to answer questions about her/his collaboration with the physician with whom she/he was worked recently, and each physician was asked about her/his collaboration with the pharmacist with whom she/he was worked recently as well. A McDonough and Doucette model was used to assess the status of inter-professional collaboration and factors affecting physicians\u0026rsquo; and pharmacists\u0026rsquo; collaboration during treatment of their common patients. The model includes independent variables that affect physician-pharmacist collaboration, including demographics, professional experience, and exchange characteristics including trustworthiness, role specification, and relationship initiation.\u003c/p\u003e\u003cp\u003eThe pharmacist-physician collaboration instrument (PPCI) has 14 questions, with scores ranging from 14 to 92; higher scores show better collaboration. The PPCI evaluates three domains of collaborative relationships: trustworthiness, role specification, and relationship initiation, which are rated on a 7-point Likert scale from 1 (very strongly disagree) to 7 (very strongly agree). The scoring ranges are 6\u0026ndash;42 for trustworthiness (6 questions), 5\u0026ndash;35 for role specification (5 questions), and 3\u0026ndash;21 for relationship initiation (3 questions). Additionally, demographic variables such as age, gender, experience, and practice area are collected, as these may affect collaboration.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eData Quality Assurance\u003c/h3\u003e\n\u003cp\u003eTo ensure data quality, we clearly elaborated about the research and questioners administer to the participants. The collected data was thoroughly checked for completeness and consistency by principal investigators. Two day training was given for data collector and supervisor. The training covered data collection processes with Kobo tool and study objectives. It also covers timely data collecting and submission of collected data. The supervisors check Completeness of each questionnaire during data collection process.\u003c/p\u003e\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003eData Analysis\u003c/h2\u003e\u003cp\u003eData collected using kobo toolbox was then transferred to SPSS software version 26 for analysis to identify trends and correlations. The analysis techniques used include descriptive statistics and multiple logistic regressions.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eEthical Considerations\u003c/h2\u003e\u003cp\u003e A formal letter of ethical approval was obtained from the Ethical Review Board of the School of Pharmacy, College of Medicine and Health Science, University of Gondar, with protocol number SOP 087/10/05/2025. This study done following the principles outlined in the Declaration of Helsinki, ensuring ethical standards were met. The confidentiality of the study participants was kept by assigning unique identifiers during data collection. Oral informed consent was obtained from all study participants, ensuring that their participation is voluntary. The name and address of the participants was not recorded to ensure their privacy. Participants were allowed to discontinue the research at any time.\u003c/p\u003e\u003c/div\u003e"},{"header":"RESULT","content":"\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003cdiv id=\"Sec13\" class=\"Section3\"\u003e\u003ch2\u003eRespondent Characteristics\u003c/h2\u003e\u003cp\u003eThere were 161 pharmacists and Physician participated. The participants ranged in ages (\u003cspan additionalcitationids=\"CR26 CR27 CR28 CR29\" citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e) ages 67 (37.1%), and from 31\u0026ndash;40 years cover 86 (57.1%). The majority of participants were male (98, 52%), and had working experience of 5\u0026ndash;10 years (164, 42.9%). The mean age of the pharmacists was younger (30.35 years old) than that of the physicians (37.99 years old). Thus, the physicians had a longer period of practice (11.32 years) than pharmacists (5.45 years). Most pharmacists were male (67.7%), while majority of physicians were female (56.3%) as presented in Table \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSocio-demographic Characteristics\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eIndividual characteristics\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003ePharmacist\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePhysician\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFrequency (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eFrequency (%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eSex\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e44 (67.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e54(56.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e21 (32.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e42 (43.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e25\u0026ndash;30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e24 (37.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e43 (45%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e31\u0026ndash;40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e37 (57.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e49 (51.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4 (5.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3 (5.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eYears of experience\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e28 (43.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e69 (71.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e31 (46.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e27 (28.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003ePractice area of pharmacist\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOPD pharmacy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e21(32.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEmergency pharmacy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9(13.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eInpatient pharmacy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e22(33.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eART pharmacy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13(\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e\u003cp\u003ePractice area of physician\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eInternal medicine ward\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e29 (30.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePediatric ward\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17(17.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSurgical ward\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e13(13.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOPD ward\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17(17.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEmergency Ward\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8(8.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGyna and Obs ward.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12(12.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eKeys: All data are \u003cem\u003eN\u003c/em\u003e (%) or mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003eTeam-based Physician\u0026ndash;Pharmacist Collaboration\u003c/h2\u003e\u003cp\u003eThe multi-item variables showed good internal consistency reliability (Cronbach\u0026rsquo;s alpha (α) values\u0026thinsp;\u0026ge;\u0026thinsp;0.8) for both pharmacists and physicians as presented in Table. There was no significant difference between the mean scores of physicians and pharmacists for trustworthiness and role specification domains. The Mean trustworthiness score for physician was (31.92\u0026thinsp;\u0026plusmn;\u0026thinsp;2.3 out of 42) and for role specification (27.33\u0026thinsp;\u0026plusmn;\u0026thinsp;4.1 out of 35) whereas the mean pharmacists trustworthiness (32.31\u0026thinsp;\u0026plusmn;\u0026thinsp;3.4 out of 42) and role specification (28.53\u0026thinsp;\u0026plusmn;\u0026thinsp;4.1 out of 35) as detailed in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e. However, Pharmacists had higher scores in relationship initiation (11.78\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;2.3 out of 21) and collaborative care (26.6\u0026thinsp;\u0026plusmn;\u0026thinsp;3.7 out of 35) than physicians with score of 9.87\u0026thinsp;\u0026plusmn;\u0026thinsp;2.5 out of 21 and 19.78\u0026thinsp;\u0026plusmn;\u0026thinsp;3.6 out of 35, respectively. Pharmacists were more likely to initiate relationships and collaborate than physicians (p-value\u0026thinsp;\u0026le;\u0026thinsp;0.05).\u003c/p\u003e\u003cp\u003eHowever, both professionals had less likelihood to collaborate according to the 7-point likert scale as shown in Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ePharmacist and physician-rated Physician-Pharmacist Collaboration Index (PPCI) domain scores\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eDomains (Range)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003ePharmacist- rated\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003ePhysician-rated\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePPCI score (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eCronbach\u0026rsquo;s alpha\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePPCI score (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCronbach\u0026rsquo;s alpha\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTrustworthiness (6\u0026ndash;42)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e32.31\u0026thinsp;\u0026plusmn;\u0026thinsp;3.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e31.92\u0026thinsp;\u0026plusmn;\u0026thinsp;2.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.87\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRole specification (5\u0026ndash;35)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e28.53\u0026thinsp;\u0026plusmn;\u0026thinsp;4.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e27.33\u0026thinsp;\u0026plusmn;\u0026thinsp;4.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.83\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRelationship initiation (\u003cspan additionalcitationids=\"CR4 CR5 CR6 CR7 CR8 CR9 CR10 CR11 CR12 CR13 CR14 CR15 CR16 CR17 CR18 CR19 CR20\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e11.78\u0026thinsp;\u0026plusmn;\u0026thinsp;2.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11.78\u0026thinsp;\u0026plusmn;\u0026thinsp;2.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal score (14\u0026ndash;92)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e72.62\u0026thinsp;+\u0026thinsp;9.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e71.03\u0026thinsp;+\u0026thinsp;3.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCollaborative care (5\u0026ndash;35)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e26.6\u0026thinsp;\u0026plusmn;\u0026thinsp;3.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e24.2\u0026thinsp;\u0026plusmn;\u0026thinsp;3.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe multiple linear regression analysis evaluated using different independent variables, including demographic characteristics, area of practice, and dimensions of interprofessional collaboration. The results showed that sex, age category, and years of experience were not significant (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05), indicating these factors did not affect the interprofessional collaboration. Regarding the area of practice, pharmacists working in inpatient and antiretroviral therapy pharmacies significantly outcome scores compared to outpatient department (p\u0026thinsp;=\u0026thinsp;0.03; and p\u0026thinsp;=\u0026thinsp;0.04, respectively). This result showed that professionals in these settings may have better collaborative experiences with measured outcome. Among the domains of collaboration, trustworthiness showed a negative but non-significant association (p\u0026thinsp;=\u0026thinsp;0.29). However, both role specification (p\u0026thinsp;=\u0026thinsp;0.01) and relationship initiation ( p\u0026thinsp;=\u0026thinsp;0.00) were significant predictors, implying that clear role definition and proactive relationship-building among professionals contribute positively to the outcome as presented in Table \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003emultiple regression analysis of factors affecting the collaborative care for the pharmacists\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIndependent variables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBeta coefficients\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.56\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge category\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e25-30\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.61\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e31-40\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.63\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;41\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-2.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.24\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eYears of experience\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.79\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eArea of practice\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOPD pharmacy\u0026nbsp;\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.74\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEmergency pharmacy\u0026nbsp;\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.59\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInpatient pharmacy\u0026nbsp;\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.04*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eART pharmacy\u0026nbsp;\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.02*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTrustworthiness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.33\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRole specification\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.04*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRelationship initiation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.01*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"3\"\u003eKeys: a Age\u0026thinsp;\u0026ge;\u0026thinsp;41 is the reference, physicians with \u0026gt;\u0026thinsp;5 years of experience, female is a reference b Drug store is the reference, *p\u0026thinsp;\u0026lt;\u0026thinsp;0.05\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe multiple linear regression analysis evaluated the factors that affect collaboration among physicians. The result showed that \u003cb\u003esex\u003c/b\u003e had negative but non-significant association with collaboration (p\u0026thinsp;=\u0026thinsp;0.08), demonstrating that male and female physicians did not have significant difference in collaboration. Regarding age, physicians aged 25\u0026ndash;30 years (p\u0026thinsp;=\u0026thinsp;0.61) and 31\u0026ndash;40 years (p\u0026thinsp;=\u0026thinsp;0.3) showed no significant differences compared to those aged above 41 years. Similarly, years of experience (\u0026le;\u0026thinsp;5 years) showed negative but non-significant effect (p\u0026thinsp;=\u0026thinsp;0.77), implying that experience did not significantly affect physicians\u0026rsquo; collaboration.\u003c/p\u003e\u003cp\u003eWith respect to the area of practice, physicians in the internal medicine ward showed a significant positive relationship with collaboration (p\u0026thinsp;=\u0026thinsp;0.01), indicating that those in internal ward showed significant collaboration compared to the general ward. In contrast, physicians in pediatric ward, surgical ward, outpatient department, and emergency ward did not show significant associations with collaboration. Among domain of interprofessional collaboration, trustworthiness (p\u0026thinsp;=\u0026thinsp;0.03) and relationship initiation (p\u0026thinsp;=\u0026thinsp;0.01) were significant positive predictors of collaborative care among physicians as presented in Table \u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e. This shows that physicians who demonstrated higher levels of trust and proactively initiated professional relationships were more likely involve in collaboration. However, role specification (p\u0026thinsp;=\u0026thinsp;0.5) did not have significant effect, suggesting that defined roles alone may not be sufficient to enhance collaboration.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eMultiple regression analysis of factors affecting collaboration for physicians\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIndependent variables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBeta coefficients\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-1.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.08\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge category in years\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e25-30\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-1.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.62\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e30-40\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-1.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e45\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-4.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.04*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYears of experience in years (\u0026le;\u0026thinsp;5)\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.63\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eArea of practice\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInternal medicine ward\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.02*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePediatric ward\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.73\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSurgical ward\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.78\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOPD ward\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.63\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEmergency Ward\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-1.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.34\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTrustworthiness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.04*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRole specification\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.71\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRelationship initiation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.02*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"3\"\u003e\u003cb\u003eKeys\u003c/b\u003e : a Age\u0026thinsp;\u0026ge;\u0026thinsp;41 is the reference group, female is the reference, general ward is the reference for practicing area, *p\u0026thinsp;\u0026lt;\u0026thinsp;0.05\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eEffective collaboration between physicians and pharmacists recognized as a major factor to improve patient outcomes, enhance medication safety, and increase healthcare efficiency(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). The current study assessed the extent of interprofessional collaboration between physicians and pharmacists at the University of Gondar Comprehensive Specialized Hospital using the validated Physician\u0026ndash;Pharmacist Collaboration Index (PPCI).\u003c/p\u003e\u003cp\u003eThis study showed that Pharmacists who worked in close collaboration with physicians showed significantly higher pharmacist-rated PPCI scores (\u003cb\u003emean\u003c/b\u003e 72.62\u0026thinsp;+\u0026thinsp;9.6), suggesting that pharmacists perceived strong professional relationships and active participation in patient care. This result showed that physicians viewed pharmacists as credible, trustworthy partners in patient management, consistent with earlier studies emphasizing that mutual trust, respect, and recognition of professional expertise are key factor for collaboration(\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). The mean PPCI scores in this study were comparable to those reported by Snyder et al. (2010)(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e), who found a total PPCI score of 89.8\u0026thinsp;\u0026plusmn;\u0026thinsp;4.6 among pharmacist\u0026ndash;physician pairs, suggesting a moderate-to-strong collaboration. Although collaboration levels were positive, results also revealed that the relationships between physicians and pharmacists require continued effort and support. As reported in previous studies, collaboration flourish when built upon shared goals, role clarity, and sustained communication (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). This study reinforces that these relational and organizational factors are more important than demographic characteristics in predicting collaborative practice.\u003c/p\u003e\u003cp\u003eIndeed, in this study, demographic factors such as sex, age, and years of experience were not significantly associated with collaboration among both pharmacists and physicians. This result aligns with previous studies showing that demographic factors alone may not determine collaboration (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). The lack of significance suggests that collaboration may affected by professional, organizational, and relational factors than by personal attributes.\u003c/p\u003e\u003cp\u003eHowever, the mean age difference between pharmacists (30.35 years) and physicians (37.99 years) implies that physicians had longer professional exposure, which may contribute to different perceptions of collaboration. Interestingly, physicians aged 36\u0026ndash;45 years showed significant negative association with collaborative care, indicating reduced collaboration. This result may show role fatigue or hierarchical professional culture, as mid-career physicians may prioritize autonomy over team decision-making (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). Similar results were reported in previous studies, where age and experience correlate inversely with openness to interprofessional collaboration (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe area of professional practice significantly influenced collaborative engagement. Pharmacists working in inpatient and ART (antiretroviral therapy) pharmacies had higher collaboration scores compared to those in OPD or emergency pharmacies. These settings need continuous interaction between physicians and pharmacists to optimize therapy, especially in ART pharmacy where polypharmacy and adherence monitoring are critical(\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). Similarly, physicians in the internal medicine ward reported stronger collaboration than those in other wards. Internal medicine usually needs multidisciplinary input for chronic disease treatment, thereby fostering structured communication and teamwork (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). In contrast, lower collaboration scores found in the surgical and emergency wards might be related to high patient turnover, which may limit interprofessional discussion (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). These results proposed that institutional policies facilitate collaboration and communication systems across all departments are important to increase teamwork.\u003c/p\u003e\u003cp\u003eAmong the dimensions of collaboration, relationship initiation \u003cem\u003eand\u003c/em\u003e role specification emerged as significant positive predictors of collaborative care among pharmacists, whereas trustworthiness \u003cem\u003eand\u003c/em\u003e relationship \u003cem\u003einitiation\u003c/em\u003e were significant among physicians. These findings reinforce the multidimensional nature of interprofessional collaboration and the importance of interpersonal and organizational clarity in fostering teamwork. The strong predictive value of relationship initiation highlights that proactive communication and willingness to engage are key facilitators of collaboration(\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). Pharmacists\u0026rsquo; higher scores in this domain indicate their active efforts to establish professional relationships, likely reflecting the growing recognition of pharmacists\u0026rsquo; clinical roles within multidisciplinary teams (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe physician responses showed that relationship initiation had a significant positive relationship with collaboration. Physicians may be better positioned to initiate interprofessional relationships due to their decision-making authority and clinical leadership roles (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). In several healthcare settings, physicians possess greater institutional power in treatment decision-making, which may affect how collaboration initiates and develops. As such, when physicians initiate professional relationships, the collaboration process tends to progress more rapidly, reflecting a hierarchical but cooperative dynamic (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e\u003cp\u003ePhysicians may also expect the pharmacists to introduce and offer their collaboration in drug selection. However, most physicians do not have regular visits to hospital pharmacy to be updated with new medications and that may have a chance to build physician\u0026ndash;pharmacist relationships. The presence of pharmacists at daily morning rounds, when medication selection done might facilitate collaboration. Thus, physicians who had pharmacists help initiate the relationship were able to move into the more collaborative stage (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eRole specification allows each professional to clearly understand and respect the responsibilities of the other. For instance, while physicians prescribe medications, pharmacists contribute via medication review, error detection, and provide drug-related infomation\u0026mdash;creating a complementary relationship that enhances patient safety. The positive effect of role specification among pharmacists shows that clarity in responsibilities enhances mutual respect and efficiency. Clear role understanding reduces professional ambiguity and minimizes role conflict, thereby supporting smoother coordination of patient care(\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). Conversely, the lack of significance of role specification among physicians may suggest that hierarchical structures or physician-dominated models of care persist, potentially undermining shared responsibility(\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eTrustworthiness was positively associated with collaboration among pharmacists and physicians. Mutual trust forms the foundation of effective team functioning(\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). Mutual trust encourages open communication, shared decision-making, and reduces professional conflicts which affect collaboration (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). A study done in the UK also emphasized that trustworthiness is foundational element to foster the exchange between pharmacist and physician. Both professionals work to acquire mutual trust. The best way to increase physician\u0026rsquo;s trust to pharmacist is by showing competence via evidence-based clinical recommendations that improve patient safety. When mutual trust is built, the collaboration level will improve. Studies have similarly shown that frequent contact and shared decision-making environments contribute increase collaborative trust (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e),(\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). However, when such opportunities are limited, as in outpatient or emergency settings, professional collaboration may be hindered. However, other studies reported, some physicians may resist pharmacists\u0026rsquo; input due to traditional role perceptions or professional autonomy, suggesting that institutional and cultural change is also necessary (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThis study also showed that collaboration was affected by professional practice setting. The management barriers can be reduced by working with similar hospital setting. We supposed that physicians and pharmacists working within same hospital would have more chance to collaborate as they have face-to-face contact and less administrative barriers. In particular, pharmacists working in inpatient and antiretroviral therapy pharmacies showed higher collaboration scores, likely due to the complexity of treatments requiring coordinated input from multiple professionals. Similarly, physicians working in internal medicine wards\u0026mdash;where multidisciplinary approaches are common\u0026mdash;showed significantly greater collaboration. These observations align with the view that proximity and structured teamwork environments enhance interprofessional relationships(\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e).\u003c/p\u003e\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\u003ch2\u003eStrengths and Limitations\u003c/h2\u003e\u003cp\u003eThe present study provides valuable insight into physician\u0026ndash;pharmacist collaboration at University of Gondar Comprehensive Specialized Referral Hospital a setting where such studies are limited. It is one of the few studies to use the PPCI tool to assess interprofessional collaboration in an inpatient environment. However, the study has certain limitations. First, the data were collected from a single institution (University of Gondar Comprehensive Specialized Hospital), limiting generalizability to other healthcare settings. Second, the cross-sectional design prevents causal inference. Longitudinal studies would be beneficial to assess how collaboration evolves over time and how interventions such as joint rounds or interprofessional training influence PPCI scores.\u003c/p\u003e\u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn conclusion, IPC between pharmacists and physicians at the University of Gondar Comprehensive Specialized Hospital was moderate but promising. While pharmacists were perceived as trustworthy and engaged, collaboration remained suboptimal due to factors such as communication barriers, and limited structured opportunities for interaction. Relationship initiation, trustworthiness, and role clarity were key facilitators of successful collaboration. To strengthen IPC, the Hospital management should promote joint clinical rounds, interprofessional education, and structured communication channels that build mutual trust and professional respect. Addressing these factors is crucial for developing a sustainable collaborative culture that ultimately enhances patient safety and clinical outcomes.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eIPC; interprofessional collaboration, PPCI: Physician\u0026ndash;Pharmacist Collaboration Index\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe University of Gondar review board sought ethical clearance from the ethical review committee of the school of pharmacy. Oral informed consent was obtained from each study participant after the purpose of the study was explained.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot Applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll the data generated during this study included within the article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere weren\u0026apos;t any conflicting interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot funded\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026quot;T.A, and A.B.\u0026nbsp;participated in Conceptualization, Data analysis, Investigation, Methodology, Supervision, Validation, Visualization, Writing - original draft. \u0026nbsp;\u0026nbsp;T .M, S.A and A.B contributed in data analysis, writing - review \u0026amp; editing the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study participants, University of Gondar, and authors of this study are gratefully acknowledged.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eMoloro AH, Sabo KG, Lahole BK, Wengoro BF, Mare KU. Prevalence of interprofessional collaboration towards patient care and associated factors among nurses and physician in Ethiopia, 2024: a systematic review and meta-analysis. BMC Nurs. 2025;24(1):210.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eOrganization WH. Framework for action on interprofessional education and collaborative practice. 2010.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDegu T, Amsalu E, Kebede A, Adal O. Inter-professional collaboration and associated factors among nurses and physicians in specialized public hospitals, the northwest, Ethiopia: mixed method multi-centered cross-sectional study. BMC Health Serv Res. 2023;23(1):286.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGemmechu WD, Eticha EM. Factors influencing the degree of physician-pharmacists collaboration within governmental hospitals of Jigjiga Town, Somali National Regional State, Ethiopia, 2020. BMC Health Serv Res. 2021;21(1):1269.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003evan Diggele C, Roberts C, Burgess A, Mellis C. Interprofessional education: tips for design and implementation. BMC Med Educ. 2020;20(Suppl 2):455.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePerepelkin J, Dobson RT. Influence of ownership type on role orientation, role affinity, and role conflict among community pharmacy managers and owners in Canada. Res Social Adm Pharm. 2010;6(4):280\u0026ndash;92.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAwalom MT, Kidane ME, Abraha BW. Physicians\u0026rsquo; views on the professional roles of pharmacists in patient care in Eritrea. Int J Clin Pharm. 2013;35(5):841\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBrock KA, Doucette WR. Collaborative working relationships between pharmacists and physicians: an exploratory study. J Am Pharm Assoc (2003). 2004;44(3):358\u0026thinsp;\u0026ndash;\u0026thinsp;65.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAl-Jumaili AA, Al-Rekabi MD, Doucette W, Hussein AH, Abbas HK, Hussein FH. Factors influencing the degree of physician-pharmacist collaboration within Iraqi public healthcare settings. Int J Pharm Pract. 2017;25(6):411\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSimpson SH, Majumdar SR, Tsuyuki RT, Lewanczuk RZ, Spooner R, Johnson JA. Effect of adding pharmacists to primary care teams on blood pressure control in patients with type 2 diabetes: a randomized controlled trial. Diabetes Care. 2011;34(1):20\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTimothewos S. Interprofessional Collaboration between Physicians and Pharmacists in Selected Public Hospitals of Addis Ababa. 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Part 2: factors, processes and outcomes. J Interprof Care. 2005;19(sup1):39\u0026ndash;48.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZwarenstein M, Goldman J, Reeves S. Interprofessional collaboration: effects of practice-based interventions on professional practice and healthcare outcomes. Cochrane database Syst reviews. 2009(3).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePelone F, Harrison R, Goldman J, Zwarenstein M. Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane database Syst reviews. 2017(6).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSupper I, Catala O, Lustman M, Chemla C, Bourgueil Y, Letrilliart L. Interprofessional collaboration in primary health care: a review of facilitators and barriers perceived by involved actors. J Public Health. 2015;37(4):716\u0026ndash;27.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKwan Y, Fernandes OA, Nagge JJ, Wong GG, Huh J-H, Hurn DA, et al. Pharmacist medication assessments in a surgical preadmission clinic. Arch Intern Med. 2007;167(10):1034\u0026ndash;40.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKaboli PJ, Hoth AB, McClimon BJ, Schnipper JL. Clinical pharmacists and inpatient medical care: a systematic review. Arch Intern Med. 2006;166(9):955\u0026ndash;64.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eL\u0026ouml;ffler C, Koudmani C, B\u0026ouml;hmer F, Paschka SD, H\u0026ouml;ck J, Drewelow E, et al. Perceptions of interprofessional collaboration of general practitioners and community pharmacists-a qualitative study. BMC Health Serv Res. 2017;17(1):224.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMakowsky MJ, Schindel TJ, Rosenthal M, Campbell K, Tsuyuki RT, Madill HM. Collaboration between pharmacists, physicians and nurse practitioners: a qualitative investigation of working relationships in the inpatient medical setting. J Interprof Care. 2009;23(2):169\u0026ndash;84.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZillich AJ, McDonough RP, Carter BL, Doucette WR. Influential characteristics of physician/pharmacist collaborative relationships. Ann Pharmacother. 2004;38(5):764\u0026ndash;70.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSalim AM, Elgizoli B. Exploring the reasons why pharmacists dispense antibiotics without prescriptions in Khartoum state, Sudan. Int J Pharm Pract. 2017;25(1):59\u0026ndash;65.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eD'amour D, Ferrada-Videla M, San Martin Rodriguez L, Beaulieu M-D. The conceptual basis for interprofessional collaboration: Core concepts and theoretical frameworks. J Interprof Care. 2005;19(sup1):116\u0026ndash;31.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMallinder A, Martini N. Exploring community pharmacists\u0026rsquo; clinical decision-making using think aloud and protocol analysis. Res Social Administrative Pharm. 2022;18(4):2606\u0026ndash;14.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBradley F, Elvey R, Ashcroft DM, Hassell K, Kendall J, Sibbald B, et al. The challenge of integrating community pharmacists into the primary health care team: a case study of local pharmaceutical services (LPS) pilots and interprofessional collaboration. J Interprof Care. 2008;22(4):387\u0026ndash;98.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Interprofessional collaboration, Trustworthiness, Role specification, Relationship initiation, Ethiopia","lastPublishedDoi":"10.21203/rs.3.rs-7954442/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7954442/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eInter-professional collaboration occurs when healthcare professions work together to achieve common goals. It involves communication and decision-making. Inter-professional collaboration between healthcare professionals improves drug safety, patient outcome and minimizes healthcare costs. In Ethiopia, the extent of collaboration remains underexplored. This study evaluates the degree of collaboration and factors affecting collaboration between physicians and pharmacists within University of Gondar Comprehensive Specialized Hospital.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA Hospital-based cross-sectional study was conducted from September to October 2025 among physicians and pharmacists working at the University of Gondar Comprehensive Specialized Referral Hospital. Data were collected using a standardized questionnaire based on the Physician\u0026ndash;Pharmacist Collaboration Index (PPCI). The PPCI assesses three domains\u0026mdash;trustworthiness, role specification, and relationship initiation. Data were analyzed using SPSS version 26, employing descriptive statistics and multiple linear regressions to identify factors associated with collaborative care.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eA total of 161 professionals (96 physicians and 65 pharmacists) participated. The mean PPCI score was 72.6\u0026thinsp;\u0026plusmn;\u0026thinsp;9.6 for pharmacists and 71.0\u0026thinsp;\u0026plusmn;\u0026thinsp;3.2 for physicians, indicating moderate collaboration. Pharmacists scored higher than physicians in relationship initiation (11.78\u0026thinsp;\u0026plusmn;\u0026thinsp;2.3 vs. 9.87\u0026thinsp;\u0026plusmn;\u0026thinsp;2.5; p\u0026thinsp;\u0026le;\u0026thinsp;0.05) and collaborative care (26.6\u0026thinsp;\u0026plusmn;\u0026thinsp;3.7 vs. 24.2\u0026thinsp;\u0026plusmn;\u0026thinsp;3.4; p\u0026thinsp;\u0026le;\u0026thinsp;0.05). Regression analysis showed that pharmacists working in inpatient (p\u0026thinsp;=\u0026thinsp;0.04) and ART pharmacies (p\u0026thinsp;=\u0026thinsp;0.02) reported higher collaboration scores compared to those in outpatient settings. Among collaboration domains, role specification (p\u0026thinsp;=\u0026thinsp;0.04) and relationship initiation (p\u0026thinsp;=\u0026thinsp;0.01) significantly predicted collaborative care among pharmacists. For physicians, collaboration was significantly associated with working in the internal medicine ward (p\u0026thinsp;=\u0026thinsp;0.02), trustworthiness (p\u0026thinsp;=\u0026thinsp;0.04), and relationship initiation (p\u0026thinsp;=\u0026thinsp;0.02). Demographic factors such as age, sex, and years of experience were not significant predictors (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eThe study showed moderate level of collaboration between physicians and pharmacists. Role specification, relationship initiation, and professional trust were the major factor that affects collaboration, while demographic factors had less effect. Strengthening interprofessional communication, clarifying professional roles, and increase trust-based relationships are important to increase collaboration.\u003c/p\u003e","manuscriptTitle":"Inter-professional collaboration and associated factors among pharmacists and physicians at University of Gondar Specialized Hospital","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-07 15:29:32","doi":"10.21203/rs.3.rs-7954442/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"eb12c5c8-8360-4c91-a372-9c8e241b0a5c","owner":[],"postedDate":"November 7th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-11-17T00:23:10+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-07 15:29:32","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7954442","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7954442","identity":"rs-7954442","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}