Abstract
Objective To characterise the counselling behaviour of practitioners providing a pharmaceutical care (PC) service in community pharmacy, and to describe the content of the consultations. Setting Community pharmacies in Sweden. Methods Non-participant observations, including audio recording, of five practitioners in five different pharmacies counselling 16 patients, were analysed qualitatively using an iterative, stepwise, interpretivist approach. Main outcome measure Descriptions of counselling behaviour and content of consultations. Results The counselling behaviour was characterised by attempts to understand the patients’ narratives by listening and asking questions and a willingness to help. The computer often had an important role in consultations, being used for documentation and as a supportive tool for identification of drug–drug interactions. The practitioners often took command in the initial phase of the consultation, and omitted to determine the patients’ most urgent drug-related needs. However, counselling behaviour that identified and focused on the patient’s needs, giving the computer little attention during the consultation was also observed. Practitioners provided vague descriptions of the purpose and outline of the service. Consultations included a wide variety of issues, which potentially could help patients’ achieve optimal outcomes of medical treatment. Conclusion The practitioners provided important advice and different forms of support to patients. Focus on the computer screen limited their abilities to practise patient centred care.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Cipolle RJ, Strand LM, Moreley PC. Pharmaceutical care practice—the clinician’s guide. 2nd ed. New York: McGraw-Hill Companies Inc; 2004.
Little P, Everitt H, Williamson I, Warner G, Moore M, Gould C, Ferrier K, Payne S. Preferences of patients for patient centred approach to consultation in primary care: observational study. BMJ. 2001;322:468–72.
Kinnersley P, Stott N, Peters TJ, Harvey I. The patient-centredness of consultations and outcome in primary care. Br J Gen Pract. 1999;49:711–6.
Stewart M. Towards a global definition of patient centred care. BMJ. 2001;322:444–5.
Bultman DC, Svarstad BL. Effects of physician communication style on client medication beliefs and adherence with antidepressant treatment. Patient Educ Couns. 2000;40:173–85.
Bultman DC, Svarstad BL. Effects of pharmacist monitoring on patient satisfaction with antidepressant medication therapy. J Am Pharm Assoc (Wash). 2002;42:36–43.
Murawski MM, Miederhoff PA. Pharmaceteutical caring. Am J Pharm Educ. 1994;58:310–5.
Cronqvist A, Theorell T, Burns T, Lutzen K. Caring about—caring for: moral obligations and work responsibilities in intensive care nursing. Nurs Ethics. 2004;11:63–76.
Fjortoft N. Identifying caring behaviors of pharmacists through observations and interviews. J Am Pharm Assoc. 2006;46:582–8.
Galt K. The need to define “care” in pharmaceutical care: an examination across research, practice and education. Am J Pharm Educ. 2000;64:223–33.
Mangiapane S, Schulz M, Muhlig S, Ihle P, Schubert I, Waldmann HC. Community pharmacy-based pharmaceutical care for asthma patients. Ann Pharmacother. 2005;39:1817–22.
Herborg H, Soendergaard B, Froekjaer B, Fonnesbaek L, Jorgensen T, Hepler CD, Grainger-Rousseau TJ, Ersboell BK. Improving drug therapy for patients with asthma—Part 1: patient outcomes. J Am Pharm Assoc (Wash). 2001;41:539–50.
Vrijens B, Belmans A, Matthys K, de Klerk E, Lesaffre E. Effect of intervention through a pharmaceutical care program on patient adherence with prescribed once-daily atorvastatin. Pharmacoepidemiol Drug Saf. 2006;15:115–21.
Tsuyuki RT, Johnson JA, Teo KK, Simpson SH, Ackman ML, Biggs RS, Cave A, Chang WC, Dzavik V, Farris KB, Galvin D, Semchuk W, Taylor JG. A randomized trial of the effect of community pharmacist intervention on cholesterol risk management: the Study of Cardiovascular Risk Intervention by Pharmacists (SCRIP). Arch Intern Med. 2002;162:1149–55.
Krass I, Armour CL, Mitchell B, Brillant M, Dienaar R, Hughes J, Lau P, Peterson G, Stewart K, Taylor S, Wilkinson J. The Pharmacy Diabetes Care Program: assessment of a community pharmacy diabetes service model in Australia. Diabet Med. 2007;24:677–83.
Shah B, Chewning B. Conceptualizing and measuring pharmacist–patient communication: a review of published studies. Res Soc Adm Pharm. 2006;2:153–85.
Hargie ODW, Morrow NC, Woodman C. Pharmacists’ evaluation of key communication skills in practice. Patient Educ Couns. 2000;39:61–70.
Apoteket AB. www.apoteket.se. Accessed 9 Dec 2009.
Smith F. Research methods in pharmacy practice. London: Pharmaceutical Press; 2002.
Hill CE, Thompson BJ, Williams EN. A guide to conducting consensual qualitative research. Couns Psychol. 1997;25:517–72.
Mays N, Pope C. Qualitative research: observational methods in health care settings. BMJ. 1995;311:182–4.
Greatbatch D, Heath C, Campion P, Luff P. How do desk-top computers affect the doctor–patient interaction? Fam Pract. 1995;12:32–6.
Britten N, Stevenson FA, Barry CA, Barber N, Bradley CP. Misunderstandings in prescribing decisions in general practice: qualitative study. BMJ. 2000;320:484–8.
Renberg T, Kettis-Lindblad A, Tully MP. Exploring subjective outcomes perceived by patients receiving a pharmaceutical care service. Res Soc Adm Pharm. 2006;2:212–31.
Farris KB, Schopflocher DP. Between intention and behavior: an application of community pharmacists’ assessment of pharmaceutical care. Soc Sci Med. 1999;49:55–66.
Worley-Louis MM, Schommer JC, Finnegan JR. Construct identification and measure development for investigating pharmacist–patient relationships. Patient Educ Couns. 2003;51:229–38.
Austin Z, Gregory PA, Martin JC. Characterizing the professional relationships of community pharmacists. Res Soc Adm Pharm. 2006;2:533–46.
Ojasalo J. Managing customers expectations in professional services. Manag Serv Qual. 2001;11:200–12.
Worley MM, Schommer JC, Brown LM, Hadsall RS, Ranelli PL, Stratton TP, Uden DL. Pharmacists’ and patients’ roles in the pharmacist–patient relationship: are pharmacists and patients reading from the same relationship script? Res Soc Adm Pharm. 2007;3:47–69.
Montgomery AT, Kalvemark-Sporrong S, Tully MP, Kettis-Lindblad A. Follow-up of patients receiving a pharmaceutical care service in Sweden. J Clin Pharm Ther. 2008;33:653–62.
Montgomery AT, Kalvemark-Sporrong S, Manap N, Tully MP, Kettis-Lindblad A. Receiving a pharmaceutical care service compared to receiving standard pharmacy service in Sweden—how do patients differ with regard to perceptions of medicine use and the pharmacy encounter? Res Soc Adm Pharm 2010 (in press). Available online.
Nickman NA. (Re-)learning to care: use of service-learning as an early professionalization experience. Am J Pharm Educ. 1998;62:380–7.
Acknowledgements
We thank the practitioners who were willing to be observed in their daily work and the patients whose consultations were observed.
Funding
This study was funded by Apoteket AB. The funding received did not in any way impact on the study design or the interpretations of the results.
Conflicts of interest
Two of the authors; Anna Montgomery and Sofia Kälvemark Sporrong, were employed by Apoteket AB when the study was carried out. They were not involved in the provision of the pharmaceutical care service in any community pharmacy.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Montgomery, A.T., Kettis Lindblad, Å., Eddby, P. et al. Counselling behaviour and content in a pharmaceutical care service in Swedish community pharmacies. Pharm World Sci 32, 455–463 (2010). https://doi.org/10.1007/s11096-010-9391-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11096-010-9391-z