Introduction
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.

Methods
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.

Key findings
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.

Discussion
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.

1. Community Pharmacy Medicines Management – Trial Summary http://www.medicinesmanagement.org.uk/trial_summary.php
2. Chen J, Britten N. 'Strong medicine': an analysis of pharmacist consultations in primary care. Fam Pract. 2000 Dec; 17(6): 480-3.