Few services provided by community pharmacists have been subject to
extensive and systematic evaluation from the patient’s perspective. As part of
the national trial of the Community Pharmacy Medicines Management Service, there
was an opportunity to obtain both quantitative and qualitative feedback from
patients.1 This paper presents the results of qualitative research.
Patients were selected using purposive sampling which aimed to recruit 5-6
patients from each of nine pilot sites based on whether any recommendations
(medicines and/or lifestyle) had been made by the pharmacist; whether the
patient perceived the consultation as useful, and how satisfied the patient was
with the consultation. The findings presented relate to issues around feedback
on the consultation, perceived value of the consultation and any ‘likes’ and
‘dislikes’ of the service. In total, 49 patients participated in the
interviews whose consultation outcomes ranged from ‘no intervention’ through
to detailed recommendations about lifestyle and medication regimens.
Both positive and negative views were expressed by participants. Most
patients expressed positive views about the new service. Many felt reassured by
their discussion with the pharmacist even when they said they had not learned
anything new. Patients were not always aware of problems that pharmacists had
identified with their medicines except when the problem could be resolved
between the patient and pharmacist. Patients’ accounts suggest that
pharmacists’ consultation styles and consultation skills were variable. Some
pharmacists were reported to actively elicit the patients’ concerns whereas
others were perceived as following a pharmacist-defined agenda that might not
address issues the patient had wanted to raise. Patients’ accounts in the
interviews suggest that they perceived the service as a one-off review rather
than an ongoing input from their pharmacist. Insufficient privacy was a problem
for some patients that detracted from the service. The analysis did not show an
association between the number of issues identified by the pharmacist and the
value placed on the service by the patient. Patients’ accounts suggested that
pharmacists did not always disclose possible problems they had identified with
the patient’s medicines.
We identified a number of influences on patient perceptions of the new
service. The extent to which the pharmacist’s consultation style was
pharmacist-centred or patient-centred, and whether the pharmacist displayed ‘front-of-shop’
or ‘back-of-shop’ practice were important determinants. There has been
little published research on pharmacists’ consultation styles2.
Overall, the interviews showed that patients valued and welcomed the service.
- Community Pharmacy Medicines Management – Trial Summary http://www.medicinesmanagement.org.uk/trial_summary.php
- Chen J, Britten N. 'Strong medicine': an analysis of pharmacist
consultations in primary care. Fam Pract. 2000 Dec; 17(6): 480-3.