Abstract
Background
Counselling patients in community pharmacies is important to obtain the best usage of medicines. However, it does not seem to be sufficiently patient-centred. To become more patient-centred, communication guidelines could be used but the guidelines need to be supplemented with up-to-date research that specifies how patient-centredness takes place or could take place in the pharmacy encounters.
Aim
To use a qualitative methodology to investigate how patient-centeredness unfolds in Danish pharmacy encounters by analysing video-recorded encounters.
Method
A maximal variation sampling strategy was applied, including staff from 2 pharmacies. A preunderstanding of ‘patient-centredness’ guided the analyses with focus on the development of relationships, understanding the patient’s situation, and coordination of care. Data were then subjected to a ‘critical common-sense’ interpretation. To validate identified themes, ‘structural corroboration’, ‘researcher triangulation’, and a ‘meaning saturation process’ were carried out.
Results
Nineteen encounters were included. Overall, the staff took responsibility for ensuring patients’ optimal medicine use and focused on biomedical aspects of the treatment. Important messages conveyed by staff appeared to be that there is one correct way of taking medicines and that taking the medicine is an uncomplicated process. Patients were rarely invited to provide their perspective.
Conclusion
Staff showed commitment to ensuring patients’ optimal medicine use, but during this process, they predominantly relied on a reductionist approach to medicine. This must be addressed as it hampers patient-centredness. Suggestions for how to become more patient-centred are given.
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References
Koster ES, Blom L, Overbeeke MR, et al. Quality of pharmaceutical care at the pharmacy counter: patients’ experiences versus video observation. Patient Prefer Adher. 2016;10:363–9.
van Geffen EC, Kruijtbosch M, Egberts AC, et al. Patients’ perceptions of information received at the start of selective serotonin-reuptake inhibitor treatment: implications for community pharmacy. Ann Pharmacother. 2009;43(4):642–9.
van Geffen EC, Philbert D, van Boheemen C, et al. Patients’ satisfaction with information and experiences with counseling on cardiovascular medication received at the pharmacy. Patient Educ Couns. 2011;83(3):303–9.
Guillaumie L, Ndayizigiye A, Beaucage C, et al. Patient perspectives on the role of community pharmacists for antidepressant treatment: a qualitative study. Can Pharm J (Ott). 2018;151(2):142–8.
Kurtz SM, Silverman JD. The Calgary–Cambridge Referenced Observation Guides: an aid to defining the curriculum and organizing the teaching in communication training programmes. Med Educ. 1996;30(2):83–9.
Abdel-Tawab R, James DH, Fichtinger A, et al. Development and validation of the Medication-Related Consultation Framework (MRCF). Patient Educ Couns. 2011;83(3):451–7.
Da Costa DL, Corlett SA, Dodds LJ. A narrative review on the consultation tools available for pharmacists in the United Kingdom: do they facilitate person-centred care? Int J Pharm Pract. 2020;28(4):301–11.
Greenhill N, Anderson C, Avery A, et al. Analysis of pharmacist-patient communication using the Calgary–Cambridge guide. Patient Educ Couns. 2011;83(3):423–31.
Koster ES, van Meeteren MM, van Dijk M, et al. Patient-provider interaction during medication encounters: a study in outpatient pharmacies in the Netherlands. Patient Educ Couns. 2015;98(7):843–8.
Fosgerau CF, Kaae S. Furthering patient-centered counseling: Exploring new aspects around pharmacists’ experiences in pharmacy encounters through video-stimulated recall interviewing. Res Social Adm Pharm. 2021;17(4):723–32.
Ng YK, Shah NM, Loong LS, et al. Patient-centred care in the context of pharmacy consultations: a qualitative study with patients and pharmacists in Malaysia. J Eval Clin Pract. 2020;26(6):1638–47.
Nguyen HT. Developing interactional competence—a conversation-analytic study of patient consultations in pharmacy. New York: Palgrave Macmillan; 2012.
Langberg EM, Dyhr L, Davidsen AS. Development of the concept of patient-centredness—a systematic review. Patient Educ Couns. 2019;102(7):1228–36.
Dyche L, Epstein RM. Curiosity and medical education. Med Educ. 2011;45(7):663–8.
Fosgerau CF, Husted GR, Clemmensen NB, et al. Using qualitative methods to explore the dynamics of patients’ perspective sharing in community pharmacy counselling–conversation analysis and video-stimulated recall interviews. Pharm Pract (Granada). 2021;19(4):2582.
Kvale S. En introduktion til det kvalitative forskningsinterview. 1st ed. København: Hans Reitzels Forlag; 1997 (in Danish).
Guba E. Criteria for assessing the trustworthiness of naturalistic inquiries. ECTJ. 1981;29(2):75–91.
Hennink MM, Kaiser BN, Marconi VC. Code saturation versus meaning saturation: how many interviews are enough? Qual Health Res. 2017;27(4):591–608.
Raymond G. Grammar and social organization: yes/no interrogatives and the structure of responding. Am Sociol Rev. 2003;68(6):939–67.
Garner M, Watson MC. Using linguistic analysis to explore medicine counter assistants’ communication during consultations for nonprescription medicines. Patient Educ Couns. 2007;65(1):51–7.
Ahn AC, Tewari M, Poon CS, et al. The limits of reductionism in medicine: could systems biology offer an alternative? PLoS Med. 2006;3(6):e208.
Saunders J. The practice of clinical medicine as an art and as a science. Med Humanit. 2000;26(1):18–22.
Pharmacists’ Patient Care Process.Joint Commission of Pharmacy Practitioners 2014. https://jcpp.net/wp-content/uploads/2016/03/PatientCareProcess-with-supporting-organizations.pdf. Accessed 28 Sep 2022.
Malterud K, Siersma VD, Guassora AD. Sample size in qualitative interview studies: guided by information power. Qual Health Res. 2016;26(13):1753–60.
Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47(3):533–43.
Rogers CR. The necessary and sufficient conditions of therapeutic personality change. Psychotherapy (Chic). 2007;44(3):240–8.
Hower EG. Beyond shared decision making. J Clin Ethics. 2020;31(4):293–302.
Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55(1):68–78.
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The authors received DKK 128,600 from the Danish Pharmaceutical Association to conduct the study.
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Kaae, S., Rossing, C., Husted, G.R. et al. How patient-centredness takes place in pharmacy encounters: a critical common-sense interpretation of video-recorded meetings. Int J Clin Pharm 45, 146–153 (2023). https://doi.org/10.1007/s11096-022-01508-2
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DOI: https://doi.org/10.1007/s11096-022-01508-2