Community pharmacists' attitudes to medicines management: A qualitative study

Objective: To explore community pharmacists' knowledge of, and attitudes toward, medicines management, including concerns or barriers to offering medicines management services from community pharmacy premises. Method: Focus groups held with purposively sampled pharmacists from community, practice and research sectors in Scotland. Participants were invited to discuss community pharmacists' knowledge and experience of medicines management, concerns about providing medicines management services from community pharmacy premises, and possible effects of such services on relationships with general practitioners (GPs). Key findings: Ten pharmacists attended two focus groups. Characteristics of participants varied according to sex and employment status as well as the type and setting of the pharmacy in which they worked. Participants were familiar with the term 'medicines management' but understanding varied between and within groups and differences from and similarities to the term 'pharmaceutical care' were less clear. Concerns about the delivery of extended services included practical issues and the effect on the 'traditional' role of the community pharmacist. Views were mixed on whether medicines management could become a routine part of all community pharmacists' practice or whether it required specialisation. Pharmacists distinguish between 'patients' and 'customers' in relation to their differing needs. The relationship between pharmacists and GPs was influenced by the post held by the pharmacist and the setting of the pharmacy. Conclusions: The pharmacists in this small, regional sample expressed a wide range of attitudes and opinions about the delivery of medicines management services from community pharmacies. Useful insights were given into the practicalities of providing such services on a daily basis in the current working environment, and how pharmacists might be able to provide medicines management services in other ways. Medicines management can be seen as a reprofessionalising strategy for pharmacy, making use of the pharmacist's status as an 'expert' to enhance the natural object, the 'drug' into the object of social significance, the 'medicine'. Further research with pharmacists from other regions is needed to confirm this explanation.