Jeroen van de Pol

190 Appendices Chapter 3 describes a study on task-prioritization by community pharmacists using Q-methodology. Participating community pharmacists were asked to rank a total of 48 different daily recurring activities. A total of 166 community pharmacists participated in this study and revealed that three groups can be distinguished based on task-prioritization. Overall, activities belonging to CPS were ranked as important by all three groups. The group containing the largest number of participants ranked CPS as the most important. Quality assurance was also ranked important and on the other side, logistics and pharmacy management were ranked as unimportant overall. So this study reveals that task-prioritization can be seen as a facilitator in the shift towards CPS in daily community pharmacy practice. To increase the available time that community pharmacists have to focus on CPS, activities belonging to logistics and pharmacy management need to be delegated to other pharmacy staff members as much as possible. 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). A total of 588 patients were included with exactly 294 patients within the intervention group and 294 patients within the control group. After a 6-month period, average healthcare associated costs per patient within the control group were €4,189 ± 6,596 and €4,008 ± 6,678 within the intervention group (including the cost of the pharmacist-led CMR). The pharmacist-led CMR was estimated to cost around €199 ± 67, which leads to an average incremental cost saving of €181 for the intervention group compared to the control group. Next to this, the 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. Quality of life was slightly reduced over a 6-month period within the intervention group measured with the EQ-5D-5L. There was a likelihood of > 90% that the pharmacist-led CMR was cost saving. This chapter therefore shows that the results of the pharmacist-led CMR on quality of life of patients is inconsistent, but it can be cost-saving from a societal perspective. Therefore, this study demonstrates that CPS provided by community pharmacists is worthwhile for society to stimulate community pharmacists in spending more time on in daily community pharmacy practice. In Chapter 5.1 , we describe a study that focused on preferences and perceived importance of the general public regarding services provided by community pharmacies. This was done via an online survey among 1,500 members of the Dutch Healthcare Consumer Panel. For this study, we specifically focused on questions regarding preferences and importance regarding community pharmacy services. A total of 516 panel members completed all questions regarding preferences and importance. Analysis of the results showed that the majority preferred convenience over CPS with respect to community pharmacy services.