Jeroen van de Pol

34 Chapter 2.1 Discussion This study shows that community pharmacists have a diverse and demanding set of activities in daily practice. While pharmacists spent approximately half (51.5%) of their time on activities that require their specific professional expertise, they spent a substantial proportion of their time on semi-professional activities (35.4%) and to a lesser extent on non-professional activities (13.1%). Although all professionals want to focus on their professional tasks as much as possible, it is impossible to avoid semi- and non-professional tasks, e.g. administrative work [23]. The current study population is representative of Dutch community pharmacists, and therefore this study provides a fair representation of time utilization by community pharmacists in the Netherlands [25]. Data was collected over a 6-month period, which makes it unlikely that results in other periods would be different. Activities that mainly took place outside this timeframe would be structurally missed; however, Dutch pharmacies are generally open between 8.00 and 18.00. Although this study reveals how community pharmacists spend their time in daily practice, it does not provide insight into the quality of the activities done [14]. Findings suggest that there is ample room to increase the time spent on CPS (currently 14.2%), although this will be at the expense of other activities. Dispensing activities (15.7%) and the final prescription check (15.9%) seem to compete with CPS, as suggested by the observation that less time was spent on CPS and more time was spent on dispensing and checking prescriptions as the week progressed. Both professional organizations and policymakers emphasize the importance of an increased focus on CPS. The results of this study show that community pharmacists are still mainly occupied with traditional tasks. It will be necessary to discontinue or delegate some of these traditional tasks in order to be able to redirect attention to CPS. The dispensing process seems to be the primary candidate. Dispensing consists mainly of semi-professional activities that can be automated and delegated to other pharmacy staff. Although the final prescription check is considered a professional task and in many countries is mandatory for pharmacists, recent technological developments and in-process control mechanisms, such as barcode scanning, automated dispensing and clinical decision support systems, could render a final check by a pharmacist superfluous. These regulatory changes will be necessary in order to help pharmacists perform this task more efficiently (e.g. delegating the final check of low-risk prescriptions to pharmacy staff or support from intelligent software), and it will be necessary to demonstrate that changing these processes does not affect patient safety. However, some pharmacists may feel uncomfortable about delegating certain tasks [26].