Jeroen van de Pol

150 Chapter 5.2 Both class 3 and class 4 prefer more services related to CPS, compared to class 1 and class 2. With class 1 preferring predominantly online services and class 2 even stating a negative preference for services related to CPS. Unfortunately this study provides only limited insights regarding the association between background characteristics and preferences regarding services to be provided by community pharmacies. Class 3 contains more male participants. Suggesting that especially males prefer the dispensing of prescription drugs without a doctors’ prescription. Over all classes the great majority of patients perceive the community pharmacist as a healthcare provider. Within class 2 and 3 a relative large proportion of participants do not see the pharmacist as a health care provider. This seems a bit contradictory for class 3 as these patients want the pharmacist to counsel them on minor ailments. However, dispensing prescription medicines without a doctors’ prescription could also be considered to improve convenience and therefore the predominant reason for participants to prefer this service. Overall differences between the classes regarding background characteristics were relatively small. This suggests that despite the statistical significance of some of these differences, the background characteristics that were available may not reliably predict patients preferences for pharmacy services. Other background characteristics that were not recorded in this study, could be more important e.g. mobility, frailty and health literacy. Attributes being the least preferred by patients were track & trace and online ways of communicating with the pharmacy team, both of which are currently being increasingly implemented in community pharmacies. This could be due to the study population consisting predominantly of elderly. Moreover, this study was performed before the COVID-19 pandemic. Within the Netherlands, both patients and healthcare professionals were forced to use digital ways of communicating due to the outbreak of COVID-19. This may increase the preference of people for these forms of communication. A study focused on the amount of provision of CPS from community pharmacies during the COVID-19 pandemic showed that only a small number of community pharmacists used telepharmacy such as video calling [32]. Strengths and limitations One of the major strengths of this study is the large amount of respondents. This allowed further subgroup analysis. Also, CBC is an efficient way to elicit preferences as it presents options in which participants have to make trade-offs. This can provide more valuable information compared to a Likert-scale questionnaire. Next to this, the study population was comprised of patients who frequently visit community pharmacies.