Jeroen van de Pol

54 Chapter 2.2 Discussion The results show significant differences between community pharmacists regarding the amount of time they spend on CPS and can be divided into three groups. Pharmacists that spend more time on CPS, are especially spending less time on pharmacy management, logistics and other activities. The results show a few characteristics that may explain the difference in the amount of time being spent on CPS. However none of these characteristics is significantly associated with a different pattern of time utilization. Pharmacists that spend more time on CPS tend to consist more of locum pharmacists. In The Netherlands, when a locum pharmacist is present, there is always a resident pharmacist working in the pharmacy. So this could be the effect of task delegation, where the resident pharmacist focuses primarily on activities concerning pharmacy management and the locum pharmacist focusing primarily on CPS. Also, the residential area of where the community pharmacy is located in tends to consist of an older population in group 3 and could therefore have an increased need for CPS. Also, group 2 and 3 consist of more female pharmacists compared to group 1. This could imply that female pharmacists tend to spend more time on CPS. However, this is effect is probably due to the relatively high influx of female pharmacists into community pharmacy in the past decades. Therefore this effect is probably more likely to be attributable to age and the type of pharmacist (most younger community pharmacists work as a locum pharmacist) instead of gender. Compared to group 3, groups 1 and 2 contain more resident pharmacists that also (partially) own a community pharmacy. Resident pharmacists that own a pharmacy are more likely to be responsible for pharmacy management than locum pharmacists. This result underlines the hampering effect of managerial activities on the amount of time that can be spent on CPS. It could be expected that pharmacists working in pharmacies belonging to a chain of pharmacies or a partnership would be able to spend more time on CPS, as pharmacymanagementmaymore often be organized froma head office. However, the results do not support this. So the limited amount of time being spent on CPS due to the hampering effect of other activities seems to be present through the entire community pharmacy market. This has also been found in earlier research, also in the United States, that showed that pharmacists employed by drug chains and independent pharmacists did not differ both regarding desired and actual time spent on CPS [20, 21]. It has been suggested earlier in international literature that community pharmacists experience a lack of confidence or fear of new responsibilities when