“What counts can’t always be measured”: a qualitative exploration of general practitioners’ conceptualisation of quality for community pharmacy services

Abstract

Background The expansion of community pharmacy services is one solution to relieve pressure on general practice in the United Kingdom (UK). There is a paucity of research of general practitioners’ (GPs’) perspectives of quality of care in the community pharmacy sector. The purpose of this study was to explore GPs’: Conceptualisation of quality for community pharmacy services, including the management of acute (low acuity) conditions and defining indispensable aspects of the patient experience (‘always events’) Opinions regarding whether and how to measure quality in the community pharmacy sector Method Semi-structured interviews were conducted with GPs in the UK. GPs were recruited using the snowballing technique and professional networks. Interviews were audio-recorded, transcribed and analysed using an interpretive approach. Results Interviews were completed with 20 GPs from Scotland (n = 8) and England (n = 12). Multidimensional and inter-related concepts of quality were identified; most dimensions related to patient benefit, as well as impact on GP workload or other health service provision. Interviewees cautioned that “what counts can’t always be measured”. GPs’ expectations of quality often mirrored those of their own sector, but were ambivalent about the adoption of a quality outcome framework-type approach. Pharmacist involvement was expected to ensure quality in the management of ‘acute consultations’, however, GPs lacked awareness of community pharmacy personnel type, roles and training. Interviewees’ perceptions of quality varied by pharmacy type; independent pharmacies were sometimes associated with higher quality service delivery than larger chain organisations. Conclusions Quality frameworks for community pharmacy services could be partly informed by GP experience and expectations, but need to be contextual to reflect differences between both settings. The importance of person-centred care, consistency and continuity was emphasised together with the need for competent personnel and privacy of interactions.

Developing a quality framework for community pharmacy: a systematic review of international literature

“…However, most cross-sectional studies did not investigate confounding factors. Furthermore, only three 30 73 77 of the 21 qualitative studies reported on the influence of the researcher on the research (ie, reflexivity). While the methods used for all studies were appropriate, only three 100 102 108 of the nine Delphi studies fully described the stages of the Delphi process, including a preparatory phase, the actual ‘Delphi rounds’, interim steps of data processing and analysis and concluding steps.…”

“… 28 30 42 43 52 53 60 63 77 89 90 93 95–97 113–115 Pharmacies without a designated consultation room increase the risk of patient conversations being overheard. 30 52 60 90 96 97 Pharmacies in countries such as the UK are required to have at least one dedicated consultation room, and it is noted that pharmacists should be proactive in offering it to patients. 30 42 77 Relative to pharmacy size, where possible, the room should be spacious, ensuring it is clutter-free and gives the impression of a professional consultation room.…”

“…These studies emphasise the need for pharmacists to have knowledge of specific disease areas 61 and diagnostic skills to provide effective treatment options with correct instructions for medicine usage and storage. 30 57 69 Moreover, GPs expect pharmacists providing professional services to be competent to assess and refer patients to a GP or other healthcare provider if necessary. 30 43 …”

“… 30 57 69 Moreover, GPs expect pharmacists providing professional services to be competent to assess and refer patients to a GP or other healthcare provider if necessary. 30 43 …”

Two-way Automated Text Messaging Support From Community Pharmacies for Medication Taking in Multiple Long-term Conditions: Human-Centered Design With Nominal Group Technique Development Study

“…In addition, we included general practice as the care provider responsible for prescribing and monitoring the medication. The involvement of wider primary care in community pharmacy intervention design has also been highlighted as important by others [ 35 , 36 ].…”