“You just forget that the pharmacist is actually there…”: Views of people with long-term conditions (LTCs) on using community pharmacy for self-care support

BackgroundSelf-care support by healthcare professionals (HCPs) is a distinct holistic, patient-centred approach to managing LTCs.1 People with LTCs are regular users of community pharmacies, and dispensing and other services provide opportunities for self-care support. This study aimed to explore the views of people with LTCs on self-care and how they utilise community pharmacy for support.MethodsSemi-structured, face-to-face interviews were conducted with people with LTCs between May 2013 and June 2014. Participants were approached via a convenient sample of one General Practice and four community pharmacies in Northwest England, and four pharmacists in two Health Boards in Scotland. Forty-four participants in England and twenty-three in Scotland were identified purposively; fifteen in England and nine in Scotland were recruited and interviewed to achieve maximal variation2 of LTC type and demographics. Interview topics were developed from the literature and used as a framework for the analysis. Topics covered living with LTCs and undertaking self-care, sources of self-care support, and use of community pharmacy. All interviews were audio-taped, transcribed verbatim and analysed thematically. Interviews and data analysis were undertaken simultaneously until data saturation was reached. NHS Research Ethics and R&D approvals were obtained.ResultsParticipants’ mean age was 62 (range: 24-92) years and 16 were females. Most (80%) participants had multiple LTCs. Participants had at least one of asthma/COPD (46%), diabetes (30%) and cardiovascular diseases (24%). The main themes that emerged were structured using a predefined thematic framework based on the topic guide. Almost all participants agreed that self-care was an integral part of daily living, and that they were already engaging in self-care behaviours such as adhering to their medicines regimen. Many others suggested that they needed support in areas such as changing lifestyles, self-monitoring and access to self-care resources. Most participants indicated that support networks such as family/carers and friends were primary sources of information and support with self-care, although they also indicated that they relied on HCPs, particularly nurses in their GP practices. Almost all viewed community pharmacy as, primarily, the supplier of their prescribed medicines, and not as a resource where they could get support for self-care of their LTCs. Additionally, many were unaware of the established community pharmacy’s medicines use services; the few who had experience of these services did not view them as a resource to improve their self-care behaviours. While some participants recognized the support that community pharmacy provided to them such as with minor ailments and some public health services (e.g. stop smoking), most appeared reluctant to acknowledge community pharmacy’s role in supporting their LTCs needs, including self-care.ConclusionsWhile study participants with LTCs engaged in self-care supported by their family, friends and some HCPs, they did not view community pharmacy as playing much of a role in the management and self-care support of their LTCs. The perspectives and needs of people with LTCs need to be better understood, so that community pharmacy services can be designed so as to contribute to their self-care needs.References1. Kennedy, A., A. Rogers, and P. Bower, Support for self care for patients with chronic disease. BMJ, 2007. 335(7627): p. 968-70.2. Creswell, J.W., Qualitative inquiry & research design: choosing among five approaches. 2006, Thousand Oaks, California: SAGE Publications, Inc.