Pharmacists' Perspectives on Providing Chronic Disease Management Services in the Community — Part II: Development and Implementation of Services

Abstract

Background: The need for alternative methods of providing primary care and chronic disease management (CDM) is becoming more urgent. To understand pharmacists' role in this changing health care system, we must better understand their desire and capacity to provide these services. Methods: Key stakeholders from all facets of pharmacy practice were recruited to participate in focus groups held in Alberta and British Columbia. Qualitative methodologies involving a phenomenological approach with content analysis were used to gather and analyze information. Results: In total, 36 pharmacists participated in 8 focus groups to identify enablers and challenges to the provision of CDM (reported in Part I). The topic of how such services could be implemented in the community developed naturally from these discussions. Participants expressed a need for changes to both the physical layout of pharmacies (to incorporate private counselling spaces) and the documentation and information systems used (to improve communication and continuity of care). Furthermore, the intentions of both pharmacists and employers must be communicated effectively to all parties, including patients. Participants also identified an alternative remuneration model as being essential, to allow adequate time for provision of CDM services and to ensure that current high-quality dispensing practices can be continued. Conclusion: Pharmacists have a tremendous opportunity to change practice and to contribute more to patient care. To guide and implement such change will require that pharmacists restructure their physical and information environments, strengthen their relationships with key stakeholders and develop a sustainable model of practice that includes the needs of the business, the client (patient) and the pharmacist.