Jeroen van de Pol

189 A Summary taken to address the possibilities that community pharmacists can offer. The most important being the publication of a position paper on the future of community pharmacy practice. In this position paper, emphasis is put on the community pharmacist focusing on CPS. However, realizing this vision is accompanied with changes both within and outside the community pharmacy. Community pharmacies differ in the amount of CPS that is firmly implemented in daily practice. This suggests that different factors are at play when implementing CPS in daily practice, acting as barriers or facilitators. An important step within Kotters’ 8-step change model is identifying and understanding these factors. And subsequently overcoming these barriers and enhancing facilitating factors. Therefore, the aim of this thesis was to get more insight 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 more CPS. Chapter 2.1 and 2.2 describe community pharmacists’ time-utilization by means of self-reported work sampling, using a smartphone application to register daily activities in the community pharmacy. Participating community pharmacists were asked to register their activities during six consecutive weeks for a total of five times per working day. Chapter 2.1 reports that a total of 91 community pharmacists participated and provided 7,848 registered activities. Analysis of these activities showed that community pharmacists spend 51,5% of their time on professional activities, such as the final checking of prescriptions, clinical risk management, and CPS, with the remainder mostly spent on semi-professional activities that could be delegated to other pharmacy staff members, such as logistics and the dispensing process. They spent a limited amount of time on CPS, such as clinical medication reviews and patient counseling after hospital discharge. This chapter shows that it is feasible to collect work-sampling data using smartphone technology and that community pharmacists are most likely being hampered in their transition towards better focus on CPS due to competing nature of traditional tasks with CPS. This prevents community pharmacists in profiling themselves as pharmaceutical experts in daily practice. Chapter 2.2 presents associations between background characteristics of participants and time-utilization of the aforementioned ninety- one community pharmacists and also provided first insights into trade-offs regarding time-utilization. This chapter reports that community pharmacists who are able to spend more time on CPS, predominantly spend less time on managerial activities. Also, community pharmacists who state that they want to spend more time on direct patient contact, are already the community pharmacists spending a relative large amount of time on CPS. This could indicate that intrinsic motivation plays an important part in the amount of time being spent on CPS.