Patient Perspectives on Community Pharmacy Services

Community pharmacy practice is changing, putting a greater emphasis on patient involvement and empowerment than on physical drug products. Developing practice philosophies, such as pharmaceutical care, are operationalised through an ever-evolving service proliferation. There is, however, a paucity of studies addressing the patients’ subjective perceptions of pharmacy services. The few studies that measure the impact of pharmacy services on humanistic outcomes show little or no effect. This might be due to the services, or the assessment instruments used.The aim of this thesis was to enhance the understanding of how patients perceive community pharmacy services, their preferences for community pharmacy services, and how these services could be evaluated from the patient perspective.This was done by: 1.exploring patients’ perceptions of an existing pharmaceutical care service using in-depth interviews; 2. exploring patient preferences for the ideal pharmacy visit using Q methodology, and characterising those patient groups that have different preferences and; 3. testing the validity of the Swedish version of the Pharmaceutical Therapy-Related Quality of Life (PTRQoL)-instrument, using think aloud methodology.
Patients had vague, and sometimes erroneous, understandings about a pharmaceutical care service that they were currently receiving. They reported that the service had increased their feeling of safety, enhanced their knowledge, provided drug treatment control, and empowered them. Seven different viewpoints of the ideal pharmacy service were identified, which could be broadly divided into two groups, those emphasizing the physical drug products as central to the encounter and those seeking a relationship with the pharmacist. Some differences between the group characteristics were identified, but not specific enough to guide individualised care practice. Several problems with the validity of the PTRQoL-instrument were detected. Overall, the thesis has highlighted various aspects of patient perspectives on community pharmacy services that could be used for the development andassessment of such services.


Project development
Professionals and patients in community pharmacy practice
Health care trends and pharmacy
Philosophy of pharmacy practice
Driving forces for changing philosophy of practice
Roles of pharmacists
Pharmacy service proliferation
Importance of the patient perspective
Patients’ perspectives on community pharmacy
Comparing professionals’ and patients’ perspectives
Pharmacy services today
Evaluations of patient perspectives in pharmacy
Pharmaceutical therapy-related quality of life
Summary of introduction
Study setting
Interpersonal encounters at community pharmacies
Community pharmacy in Sweden
The patient medication record service
Methodological framework
Subjects’ reporting of subjectivity
More on Q methodology
Generalisability of contextually situated research .
Procedures and techniques
Study population
Data collection – semi-structured interviews (Paper I)
Data collection – Q-sorting (Paper II)
Data collection – questionnaire (Paper III)
Items in the questionnaire
Data collection – think-aloud interviews (Paper IV)
Data analysis – constant comparison method (Papers I and IV)
Data analysis – by-person factor analysis (Paper II)
Data analysis – statistical tests (Papers II & III)
Ethical considerations
Summary of findings
Experience of a pharmaceutical care service (Paper I)
Nature of the service
Function of the service
Outcomes of the service
Clustered viewpoints on ideal pharmacy encounters (Papers II and III)
Validity of the Swedish PTRQoL instrument (Paper IV)
Methodological considerations
Study coverage
Implications for patients
Professional implications (including professional ethics)
Professional implications (including professional ethics)
Managerial implications
Implications for research
(Lay summary in Swedish)
Appendix 1 Interview guide (English translation, Papers I and IV)
Appendix 2 Q-sample (English translation, Paper II)
Appendix 3 Factor arrays (English translation, Paper II)

Author: Renberg, Tobias

Source: Uppsala University Library

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