Abstract
BackgroundCommunity pharmacists are accessible health care professionals who encounter people with lived experience of mental illness and addictions in daily practice. Although some existing research supports that community pharmacists’ interventions result in improved patient mental health outcomes, gaps in knowledge regarding the pharmacists’ experiences with service provision to this population remain. Improving knowledge regarding the pharmacists’ experiences with mental illness and addictions service provision can facilitate a better understanding of their perspectives and be used to inform the development and implementation of interventions delivered by community pharmacists for people with lived experience of mental illness and addictions in communities.MethodsWe conducted a qualitative study using a directed content analysis and the Theoretical Domains Framework as part of our underlying theory of behaviour change and our analytic framework for theme development. The Theoretical Domains Framework facilitates understanding of behaviours of health care professionals and implementation challenges and opportunities for interventions in health care. Thematic analysis co-occurred throughout the process of the directed content analysis. We recruited community pharmacists, with experience dispensing psychotropics, at a minimum, through multiple mechanisms (e.g., professional associations) in a convenience sampling approach. Potential participants were offered the option of focus groups or interviews.ResultsData were collected from one focus group and two interviews involving six pharmacists. Theoretical Domains Framework coding was primarily weighted in two domains: social/professional role and identity and environmental context and resources. We identified five main themes in the experiences of pharmacists in mental illness and addictions care: competing interests, demands, and time; relationships, rapport, and trust; stigma; collaboration and triage; and role expectations and clarity.ConclusionsPharmacists are not practicing to their full scope of practice in mental illness and addictions care for several reasons including limitations within the work environment and lack of structures and processes in place to be fully engaged as health care professionals. More research and policy work are needed to examine better integration of pharmacists as members of the mental health care team in communities.Electronic supplementary materialThe online version of this article (doi:10.1186/s13011-016-0050-9) contains supplementary material, which is available to authorized users.
Highlights
Community pharmacists are accessible health care professionals who encounter people with lived experience of mental illness and addictions in daily practice
In mental illness and addictions care, many of these factors co-occur alongside broader changes in the funding and delivery of health care such as shorter hospitalizations, fewer inpatient beds, and increasing demands on physicians and other primary care providers to care for people with serious mental illnesses and addictions [2,3,4,5]
Design We conducted a qualitative study using directed content analysis [50, 51] guided by the Theoretical Domains Framework (TDF), which can be used to understand behaviours of health care professionals and implementation challenges and opportunities for interventions in health care [48]
Summary
Community pharmacists are accessible health care professionals who encounter people with lived experience of mental illness and addictions in daily practice. Challenges to enhancing pharmacists’ roles include factors specific to the pharmacist, their practice environment, the patients, or other variables that may limit pharmacists’ abilities in providing quality care in keeping with standards of practice and the preferences of people with lived experiences of mental illness and addictions Examples of these factors can include stigma, limitations within the context of community pharmacy practice (e.g., staffing, unpredictable workflow, privacy issues, lack of time), and issues with knowledge, skills, and competence in medication management for mental illness and addictions or other areas such as communication [12,13,14,15,16,17,18]. Limited or nonexistent remuneration for pharmacists’ services has been reported as an impediment to mental illness and addiction service delivery in community pharmacies in other areas of the world [18]
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