Acceptability of Community Pharmaceutical Care in Portugal: A Qualitative Study

Abstract

In developed countries, community pharmacists are increasingly involved in clinical care. This study aimed to explore the acceptability to users of pharmaceutical care (drug therapy monitoring and management) provided in Portuguese community pharmacies, thereby informing future practice, policy and research. Qualitative semi-structured telephone interviews with a maximum variability sample of 21 service users. Interviews were audio-taped with permission of interviewees, transcribed verbatim and analysed using the 'framework approach' with the help of NVIVO(®) software. A perception of convenient access is one of the key themes associated with acceptability to users. Four factors are central in understanding this perception: shorter waiting time; flexibility of appointments; service organization; and proximity to home. Data analysis suggests that these factors have different weights. Another key theme underpinning user acceptability is the formation of a therapeutic relationship with the pharmacist. Patients' accounts provide evidence of a trusting and collaborative relationship where the pharmacist is seen as a health care provider. Recognition of interpersonal and technical skills were associated with the formation of this relationship. Although patients generally trusted the pharmacist's ability to help, patients were unable to voice clear expectations about the service, either in terms of the pharmacist's role or expected outcomes. Acceptability to patients is mainly determined by perceptions of convenient access and the development of a therapeutic relationship with the pharmacist. Patients' expectations concerning the service are not well developed, but not necessarily low.