Community pharmacists’ experiences in mental illness and addictions care: a qualitative study

Abstract

BackgroundCommunity pharmacists are accessible health care professionals who encounter people with lived experience of mental illness and addictions in daily practice. Although some existing research supports that community pharmacists’ interventions result in improved patient mental health outcomes, gaps in knowledge regarding the pharmacists’ experiences with service provision to this population remain. Improving knowledge regarding the pharmacists’ experiences with mental illness and addictions service provision can facilitate a better understanding of their perspectives and be used to inform the development and implementation of interventions delivered by community pharmacists for people with lived experience of mental illness and addictions in communities.MethodsWe conducted a qualitative study using a directed content analysis and the Theoretical Domains Framework as part of our underlying theory of behaviour change and our analytic framework for theme development. The Theoretical Domains Framework facilitates understanding of behaviours of health care professionals and implementation challenges and opportunities for interventions in health care. Thematic analysis co-occurred throughout the process of the directed content analysis. We recruited community pharmacists, with experience dispensing psychotropics, at a minimum, through multiple mechanisms (e.g., professional associations) in a convenience sampling approach. Potential participants were offered the option of focus groups or interviews.ResultsData were collected from one focus group and two interviews involving six pharmacists. Theoretical Domains Framework coding was primarily weighted in two domains: social/professional role and identity and environmental context and resources. We identified five main themes in the experiences of pharmacists in mental illness and addictions care: competing interests, demands, and time; relationships, rapport, and trust; stigma; collaboration and triage; and role expectations and clarity.ConclusionsPharmacists are not practicing to their full scope of practice in mental illness and addictions care for several reasons including limitations within the work environment and lack of structures and processes in place to be fully engaged as health care professionals. More research and policy work are needed to examine better integration of pharmacists as members of the mental health care team in communities.Electronic supplementary materialThe online version of this article (doi:10.1186/s13011-016-0050-9) contains supplementary material, which is available to authorized users.

Solidarity or dissonance? A systematic review of pharmacist and GP views on community pharmacy services in the UK

“…Nonetheless, pharmacists’ and GPs’ attitudes towards extended services in this review reflected international findings, where pharmacists in North America, Asia, Australasia, South America and Europe were also enthusiastic towards the concept of providing extended services (Dosea et al., ; Fang, Yang, Feng, Ni, & Zhang, ; Kinsey, Scahill, Bye, & Harrison, ; Kjome, Sandberg, & Granas, ; Schindel et al., ). Moreover, lack of awareness (Bjorkman, Viberg, Rydberg, & Stalsby Lundborg, ; Fakih, Marriott, & Hussainy, ; Freeman, Cottrell, Kyle, Williams, & Nissen, ; Wibowo, Sunderland, & Hughes, ), issues with community pharmacy premises (Babiker, Carson, & Awaisu, ; Bjorkman et al., ; Donald et al., ; Gray, Chamberlain, & Morris, ; Hattingh, Emmerton, Ng Cheong Tin, & Green, ; Murphy et al., ), lack of management support (Casserlie & Mager, ; Donald et al., ; Kinsey et al., ; Tsao et al., ; Watkins, McKee, Hughes, & Pfeiffenberger, ) and remuneration (Donald et al., ; Gray et al., ; Kinsey et al., ; Watkins et al., ) have also been found in other countries. Many pharmacists elsewhere also stressed the need for sufficient pharmacy staff (Casserlie & Mager, ; Gray et al., ; Kinsey et al., ; Murphy et al., ; Tsao et al., ), and pharmacists’(Donald et al., ; Jorgenson, Laubscher, Lyons, & Palmer, ; Watkins et al., ; Wibowo et al., ) and GPs’ (Bryant, Coster, Gamble, & McCormick, ; Dhillon et al., ; Tan, Stewart, Elliott, & George, ) views confirmed poor engagement between pharmacists and GPs.…”

Perceived Barriers and Facilitators to Providing Methadone Maintenance Treatment Among Rural Community Pharmacists in Southwestern Ontario

“…Recent Canadian evidence has identified increased workload and inadequate staffing as challenges most community pharmacists would experience if offering addiction‐treatment services, but the rural pharmacists in this study believed that these challenges were more pronounced in a rural setting than in urban areas. With a perceived limitation to rural staffing, one strategy for mitigating increased workload and workflow disruptions could be to restrict methadone dispensing hours.…”

Perceptions of Nigerian final year undergraduate students of the adequacy of the pharmacy curriculum for mental health care

“…This evidence indicates an urgent need to re‐evaluate the training of pharmacists in relation to mental health care. This suggestion is apt, especially in LMICs such as Nigeria, where there is limited access to psychiatrists, and pharmacists, being the most accessible healthcare professionals, are expected to bridge the gap and help prevent negative outcomes …”