Jeroen van de Pol

173 6 General discussion Motivation Motivation can be intrinsic or extrinsic. Examples of intrinsic motivation are curiosity and a desire to change, whereas extrinsic motivation is regarded as a reward (such as financial rewards or recognition from peers) after displaying certain behavior. Both intrinsic and extrinsic motivation can create a sense of urgency according to Kotters’ 8-step change model [13]. This study has demonstrated that the majority of community pharmacists highly prioritize CPS within their daily recurring activities (chapter 3). This result suggests intrinsic motivation is more connected to CPS provision. The discrepancy between perceived priority and actual time-utilization can, however, hamper motivation. This finding can also be interpreted as an indication that current extrinsic factors motivate community pharmacists to focus their available time on activities other than CPS. Several studies have revealed that community pharmacists are motivated to take roles as healthcare providers. Community pharmacists, for example, pursue more active roles that challenge their current skill mix within the healthcare system [22]. Studies have indicated that community pharmacists’ motivation for CPS provision increased when they worked in multidisciplinary teams and received positive appraisal by other healthcare professionals (e.g., in smoking cessation programs) [77, 78]. Results from these studies suggest the importance of positive feedback. As the majority of community pharmacists already prioritize CPS (chapter 3), the opportunity to actually focus on CPS provision will likely further increase motivation. This is also expected to increase community pharmacists’ job satisfaction. It is, therefore, paramount that policymakers and professional bodies facilitate community pharmacists in focusing on CPS provision and interprofessional collaboration. Interprofessional collaboration can be stimulated by addressing it within professional guidelines. Patient needs As chapter 5.1 explains, the general public predominantly prefers convenience- related services from the pharmacy. One reason is most likely that patients predominantly visit a GP for healthcare-related matters, even if a community pharmacists is also capable of helping the patient [79]. Possibly more importantly, the results presented in chapter 5.1 suggest that the majority of the general public was healthy and not (yet) in need of CPS. Chapter 5.1 also indicates that with increasing age, preference for CPS increases. As stated, patients who had experience with CPS provided by community pharmacists were highly satisfied [26, 30, 80-84]. Furthermore, patients with positive previous experiences utilized