Patient attitudes and expectations of pharmacist-provided clinical services in clinic-based community pharmacies

While pharmacist-provided clinical services in the outpatient setting have demonstrated improved clinical, economic, and humanistic outcomes, little is known about patients‟ attitudes and perceptions regarding participation in these services. The purpose of this thesis was to qualitatively characterize patient attitudes and expectations of pharmacist-provided clinical services in the outpatient setting. This thesis was conducted within the Intermountain Healthcare system. Intermountain Healthcare is a large, integrated healthcare delivery system in Utah and Idaho that consists of 22 hospitals, 160 primary- and specialty-care clinics, home-healthcare services, and 25 hospital- and clinic-based community pharmacies. Study participants were identified using the Intermountain Healthcare system-wide Enterprise Data Warehouse. Participants were included in the study if they had been prescribed at least four chronic medications. Participants were excluded if they did not speak English or if they could not travel to Intermountain Medical Center. The first phase of this study consisted of telephone interviews of approximately 25 participants. Participants were asked to describe their current relationship with their pharmacist and physician and describe their level of trust in engaging their pharmacist in their overall healthcare. The second phase consisted of four focus group sessions. Focus group participants were asked to confirm and elaborate on themes identified in telephone iv surveys, as well as react to brief presentations on medication therapy management and collaborative drug therapy management. Participants recognized pharmacists as medication experts, yet they did not currently maintain strong relationships with their pharmacists. Participants perceived that these were caused by poor communication between their providers, their pharmacist, and their payers. When asked to react to the concepts of medication therapy management and collaborative drug therapy management, participants agreed that it should be supported. Concerns related to the security of private information were expressed. Questions regarding how this service would be perceived by physicians were raised. For example, participants were concerned that their physicians would feel as though the pharmacist was „stepping on his/her toes‟. In conclusion, participants would likely be participatory in pharmacist-provided clinical services in the outpatient setting. The design and implementation of these services should consider concerns and questions articulated by patients in this study.