Jeroen van de Pol

18 Chapter 1 So in summary, community pharmacy as a profession has been shifting its focus from traditional tasks to the provision of CPS over 30 years. Despite this long process, community pharmacists are still undergoing this transitional phase. This exemplifies the complexity of a major change in a profession and therefore also the necessity to identify barriers and opportunities to support the profession achieving change. Objectives The aim of this thesis was to get more insights into current community pharmacy practice and to identify barriers and facilitators that either support or hamper the community pharmacy profession to shift focus on the provision of CPS in daily community pharmacy practice. The following objectives were defined: In Chapter 2.1 an overview of the daily activities of the community pharmacist is generated. As insight in the current time utilization of community pharmacists is essential before we can propose potential changes in time utilization; Chapter 2.2 identifies characteristics of community pharmacists that are able to focus more on the provision of CPS compared to those that are less able to focus on CPS provision to see if some characteristics hamper or enable community pharmacists to focus on CPS; Identifying how community pharmacists prioritize CPS is discussed in Chapter 3. CPS is compared to other activities in daily community pharmacy practice to identify the importance of CPS perceived by community pharmacists; Providing insights into the cost-effective value of CPS provided by community pharmacists, Chapter 4 discusses a cost-utility and cost-effectiveness analysis from a societal perspective of a patient-centered clinical medication review; In Chapter 5.1 the preferences of healthcare consumers in general is explored to identify the typeof services they currentlypreferwithincommunitypharmacypractice; Chapter 5.2 identifies preferences from patients regarding future services in community pharmacy practice to gain more insights on which services to further develop within the community pharmacy profession; In Chapter 6, the results presented in this thesis are put in a broader perspective, including recommendations for both community pharmacy professional bodies and policymakers.