Self-care advice in community pharmacy: a qualitative study of facilitators and barriers using the Theoretical Domains Framework

Rian Lelie- Van Der Zande, Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands

Ellen Koster, Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands

Martina Teichert, Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands

Marcel Bouvy, Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands

ABSTRACT

Background

In the Netherlands, guidelines for self-care advice for pharmacists were implemented in the 1990’s. Since then guidelines have been frequently updated. However, limited studies have been performed regarding the implementation of self-care advice. 

Objective

Evaluation of community pharmacists’ and pharmacy assistants’ perceptions on facilitators and barriers for self-care advice.

Methods

Community pharmacists and one of their assistants were invited to be interviewed. Semi-structured interviews were conducted face-to-face or online. A topic guide was developed based on Theoretical Domains Framework (TDF). Interviews were audio-recorded and transcribed verbatim. Transcripts were analyzed using  NVivo 20. Content analysis was utilized to identify facilitators and barriers in providing self-care advice.

Results

In total, 13 pharmacists and 12 pharmacy assistants were interviewed. Self-care advice was based on national guidelines including a protocol with WWHAM questions. As most important facilitators communication skills were named and active knowledge of at least first and second choice medication. Further, some pharmacists mentioned a policy on in-service training and skills assessment, and a consulting room or privacy counter as facilitators, and high workload, hurried customers, language problems, and expensive image with GPs and consumers as barriers. Most pharmacists thought GPs were unaware of policy and content of self-care advice in pharmacy.

Conclusion

Pharmacists should pay attention to in-service training, skills assessment and environmental stressors to improve quality of self-care advice in pharmacies. To improve their image they should discuss self-care advice and product prices in pharmacy with GPs.