Jeroen van de Pol

115 5 How does the general public balance convenience and cognitive pharmaceutical services Introduction There is a global trend to shift the role of the community pharmacist froma product- focus, such as compounding and dispensing medicines, to a more patient-focus, such as patient education and counselling (also known as cognitive pharmaceutical services (CPS)). This anticipated shift in focus is driven by an increasing demand for healthcare due to the ageing population and complexity of medication [1]. In daily practice however the uptake of this transition is very slow. The perception of patients about the services provided by community pharmacies may play a role in this slow uptake. Therefore it is important to study these perceptions as they could provide the profession additional information for the development of the community pharmacy profession as a whole. The Dutch healthcare system is (like other countries) currently facing shortages in the number of healthcare professionals [2,3], which might require reallocation of tasks. Pharmacists can take more responsibility for patients’ medication management. Thus, there is growing awareness among policy makers that community pharmacists can play a valuable role in the healthcare system by providing CPS [4], rather than limiting their role to solely dispensing medicines. Community pharmacists in The Netherlands are currently offering several CPS such as pharmacist-led clinical medication review (CMR) or medication adherence counselling. However, the community pharmacist is still an underused healthcare provider for counselling, despite being the most frequently visited healthcare provider with extensive expertise regarding medication [5,6]. Furthermore, the community pharmacist is often the last healthcare provider a patient sees before returning home with filled prescriptions. Especially regarding repeat prescriptions, that are often repeated without a doctors’ visit. This gives community pharmacists the opportunity, more than other healthcare professionals, to provide medication counselling and evaluate the effectiveness and safety of drug therapy on a regular basis. Any drug related problem identified by the pharmacist should subsequently be communicated to other involved healthcare professionals. In this way, community pharmacists can play a pivotal role within an integrated primary healthcare team. Many international studies have found that pharmacy services improved generic outcomes, such as medication adherence and self-management, and disease specific outcomes, such as HbA1c, blood pressure, LDL, and BMI [7- 14]. Still, patients’ utilization of these services lags behind [15-17]. Previous research indicates that community pharmacists want to spend more time on the provision of CPS [18,19]. Furthermore, patients have a positive attitude toward CPS provided by the community pharmacist if they experienced these services first-hand [20].