Jeroen van de Pol

126 Chapter 5.1 the general public, which consists of a higher proportion of people with lower educational levels, may prefer more CPS than the study’s sample. Furthermore, the proportion of participants with a migratory background was substantially lower than that of the general Dutch population (see supplementary material), and thus results cannot be generalized to the immigrant population [37]. It is expected that this group, most likely due to literacy problems, could benefit substantially from CPS and are underrepresented in this study. Furthermore, this study provides quantitative information on preferences for a limited number of services. Qualitative information may provide additional insights into the preferences of the general public. Extrapolating these results to community pharmacy practice in other countries should be done with care. As the position and role of the community pharmacist in the Netherlands could predispose the general public into preferring certain services. Especially considering the fact that the general public in the Netherlands views the community pharmacist as a healthcare provider and community pharmacies are easily accessible [38]. In other countries, accessibility of community pharmacies could be less and pharmacists could primarily be viewed as shopkeepers. Also, the payment mechanisms in the Netherlands may influence perceptions of Dutch healthcare consumers compared to consumers in other countries. In the Netherlands, prescription medication and CPS need to be paid out of pocket for the first €385 (with some forms of CPS being exempted from this). After the €385 threshold has been surpassed, patients no longer have to pay for prescription medicines or CPS. This could impact preferences and perceived importance of CPS, most probably with patients passing the €385 threshold. Implications for daily practice In this study convenience and CPS were juxtaposed. This may suggest that convenience and CPS somehow fall on opposite ends of a consumer preference spectrum. In reality, pharmacies offer a variety of services, with the type of service and convenience of that service both playing a role in the development of consumer preferences. For example, CPS will better serve the needs of more patients if it is offered in a manner which is convenient for them to obtain. The pharmacy profession needs to focus on promoting the benefits of CPS identified in numerous papers [7-14] and show that this is a core competency of the community pharmacist. Studies have found that people do not use these services because they are unaware that the services are provided [20]. Once people become acquainted with these services, demand is expected to increase automatically.