1.Challenge and Strategies in Implementing Pharmaceutical Care by Community Pharmacists:
Yoshiko TOMINAGA ; Takeshi UCHIKURA ; Shinya ABE ; Teruaki GOTO ; Muneto MURAMATSU ; Masahiro MORIOKA ; Michiko HORIGUCHI ; Mayumi MOCHIZUKI
Japanese Journal of Drug Informatics 2019;21(2):57-69
Objective: To clarify challenges and strategies to execute pharmaceutical care by community pharmacists and obtain pragmatic implications for further improvement. Design: Cross-sectional study.. Methods: We conducted a nationwide internet-based questionnaire survey about pharmaceutical care by the Japanese community pharmacists in June and July 2016. Using text data of 161 respondents, we investigated their challenges and strategies in implementing pharmaceutical care. The text data were reviewed and determined for categorization through stepwise process and reconciliation between reviewers. Results: Fourteen categories were retrieved and integrated into 4 domains (pharmacists, patients, other medical professionals, and environment) from 2 dimensions (challenges and strategies). In the challenge dimension (total n=142), communication capability (n=26), participation in medical team (n=17), patients’ understanding of pharmacists’ work (n=14), lack of timeand staff (n=14),patient- and people-centered viewpoint (n=13). Whilein thestrategy dimension (total n=72), communication capability (n=21),lack of patients’ medical information (n=18), patient- and people-centered viewpoint (n=11), lack of timeand staff (n=9), and self development (n=5). As strategies for the communication capability, attitude of acceptance and collaboration, brief explanation,utilization of visual aids, adoption of objective evaluation, various acquisition of patients’ information, active listening, and sharing patients’ information were retrieved as subcategories. The highest level of attention to communication capability implies that community pharmacists certainly recognize their expected responsibility described in the government document titled “Vision for patient-centered pharmacies”. Conclusion: Community pharmacists face many challenges but have some practical strategies. Although part of such challenges is not for pharmacists themselves but for patients, other medical professionals, or entire health system, improving essential skills of pharmacists may havepositiveinfluenceto theother challenges.