Jeroen van de Pol

74 Chapter 3 Discussion Next to similarities in task prioritization, diverging preferences (differences in emphasis) can be found in task prioritization and thereby creating three distinguishable groups: “the CPS providing pharmacist” (group 1), “the logistics focused pharmacist” (group 2) and “the (quality) management focused pharmacist” (group 3). There is a fair amount of correlation between the groups. Correlation ranges from 0.46 (between group 2 and 3) to 0.77 (between group 1 and 3) [see table 2]. This is illustrated by the fact that some activities are rated equally (un) important by all three groups. All three groups perceived CPS as important, as all three groups ranked CPS activities on average more than zero. However, pharmacists who are part of group 1 give CPS a much higher priority, which is especially reflected in high prioritization of activities with direct patient contact such as a ‘Patient interview for a medication review’ (activity 41) and ‘Counselling patients to improve medication adherence’ (activity 13). Though Q-methodology is not designed to identify prevalence, it is notable to see that participants identify most frequently with group 1 (76 out of 166). Based on table 3, pharmacists who give higher priority to CPS, seem to be willing to save time on activities such as checking prescriptions and clinical risk management alerts. These are generally considered routine tasks of pharmacists. Pharmacists in group 2 and 3 still rate these activities as very important. Based on these results, it seems that QA and PM compete with CPS over the priority given to them by the community pharmacists in this study. This is probably due to the fact that pharmacists also feel responsibility towards their traditional roles and are needed to run the pharmacy. This has several causes, one of them being that the pharmacy’s revenue is heavily dependent on logistics and dispensing and not on the provision of CPS [1]. This is partly in line with a review on consumer and pharmacists views on community pharmacy [27]. This review suggested that community pharmacists are positive about the provision of CPS, but consider these services secondary to traditional roles, such as dispensing. In a recent focus group study, some pharmacists were still reluctant to relinquish their drug distribution role [28]. The current study suggests that community pharmacists generally rank logistics as an unimportant daily activity. Some pharmacists explained in the comments that logistics do not require the expertise of a pharmacist. In the Dutch situation, logistics is mostly handled by pharmacy assistants. This is consistent with the study of Schommer et al. [11] where also a decline in the amount of time that has to be spent on logistics is preferred.