Abstract
Objective: To: 1) explore the work activities of Nebraska independent community pharmacists within the context of the pharmacy profession’s transition from a medication product focus to a patient-centered care focus; and 2) determine if a formal enhanced pharmacy service network impacted the provision of enhanced (patient-centered) pharmacy services.
Methods: Explanatory sequential mixed methods study consisting of a quantitative phase followed by a qualitative phase. In the quantitative phase, a paper-based survey was mailed to 193 pharmacists in charge of Nebraska independent community pharmacies classified into members and nonmembers of the Nebraska Enhanced Services Pharmacies (NESP) Network. The survey was used to collect data on enhanced pharmacy services offered, pharmacists’ attitudes toward enhanced services, and the planning, marketing and reimbursement mechanisms for the provision of enhanced services. Survey responses were analyzed using descriptive and inferential statistics. In the qualitative phase, an online focus group interview was conducted with three independent pharmacy owners to collect data on reasons and profitability of the provision of enhanced services. Interview transcripts were analyzed using coding techniques to generate major themes. Quantitative and qualitative results were integrated to understand how qualitative results helped explain, confirm, and validate quantitative results.
Results: Quantitative results: Overall survey response rate was 59% (n=113) with a non-NESP response rate of 53% (80/151) and a NESP response rate of 79% (33/42). Across all respondents the average number of enhanced services offered was 17 out of 47 services studied. Comparison of means showed that NESP pharmacies provided more enhanced services (𝑥=20) than non-NESP pharmacies (𝑥=16), p=0.003. Chi-square analysis showed that NESP membership was associated with the opinion that offering enhanced services increases profits, p=0.016. Qualitative results: Major themes were “NESP pharmacies have always been taking care of people” and “profitability from enhanced services is key.”
Conclusions: Independent community pharmacies commonly provide a range of enhanced services. NESP pharmacies provided more enhanced services than non-NESP pharmacies and always took care of people by providing enhanced services. NESP membership may provide opportunities for pharmacies to offer more enhanced services to patients with the intent to improve patient-centered care.