Jeroen van de Pol

161 6 General discussion Chapter 3 describes a study on task-prioritization by community pharmacists using Q-methodology. This study reveals that participating community pharmacists regarded CPS and quality assurance (QA) as the most important activity groups. In contrast, participants regarded pharmacy management as less important than CPS and QA performed by community pharmacists. These results suggest that the majority of community pharmacists want to focus more on CPS and QA. Chapter 4 presents results from a cost-effectiveness and cost-utility analysis with data from an RCT with a pharmacist-led clinical medication review (CMR). This study indicates that a pharmacist-led CMR can lead to a reduction of €181 within a 6-months timeframe in healthcare costs from a societal perspective. Moreover, a pharmacist-led CMR leads to a slight increase in the quality of life measured with the EuroQoL – Visual Analogue Scale (EQ-VAS) and the number of complaints with (more) severe impact. Therefore, this study demonstrates that CPS provided by community pharmacists can be cost-effective and is worthwhile for community pharmacists to spend more time on. In Chapter 5.1 , we describe a study that focused on preferences and perceived importance of the general public. Data were collected via a consumer panel concerning current community pharmacy services, using an online questionnaire. We found that the majority of the general public prefers convenience-related services over CPS. However, a large proportion of the general public perceives community-pharmacist-provided CPS as important. This result likely occurred because they perceive that there may be other people in need of CPS. Chapter 5.2 further investigates preferences regarding community pharmacy services but focuses on more advanced services by chronic users of medication who probably had more experiences with community pharmacies than those discussed in chapter 5.1. For this research, a discrete choice experiment was used. This study identified four groups of patients. The first group preferred online services, the second did not have clear preferences for new services, and the third and fourth groups preferred different types of CPS. The third group had a preference for counselling with the provision of prescription drugs for minor ailments without a doctors’ prescription, and the fourth group preferred point-of- care-testing (POCT) by the community pharmacist.