The Raison D'être for the Community Pharmacy and the Community Pharmacist in Sweden: A Qualitative Interview Study

The juggling act of pharmacists in Sweden: a qualitative study on balancing healthcare professionalism and retail employment

BACKGROUND

Community pharmacies in Sweden merge a state-funded professional community service with a retail business. While previous research has recognized its challenges, less attention has been paid to the potential conflict of interest it could result in regarding the work of pharmacists. This study aims to increase understanding of how pharmacists in Sweden combine their healthcare ambitions and obligations with those concerning being employees in a retail business.

METHODS

Semi-structured interviews were conducted with 28 pharmacists employed by pharmacy chains in Sweden. The data were thematically analysed.

RESULTS

In the analysis, three themes were formulated: Different interests, The conflict between professional work & business work, and Strategies to manage the conflicts. The analysis of the data reveals that pharmacists in Sweden experience a conflict of interest. They grapple with balancing being healthcare professionals with a focus on patient care and being valued retail employees that also focus on financial results. This conflict manifests in various situations, such as time management, communication focus, preferred behaviours, and different tasks. The different strategies applied by individual pharmacists to manage the work are results of job crafting. Pharmacists employ strategies such as compromise, mandate stretching, avoidance, and acceptance to manage the conflict. However, these strategies lead to compromises in their work.

CONCLUSION

This study aimed to understand how pharmacists combine their healthcare ambitions and obligations with those of being employees in a retail business. The study demonstrated that Swedish community pharmacists need to perform a juggling act to be both professional healthcare workers and viewed as valuable retail employees. In situations when the conflict of interest occurs, the pharmacists use different strategies when determining how to prioritize between the professional work and the business work. The conflict of interest in the pharmacists' work need to be taken into consideration when discussing pharmacists practices, the profession, or role it's in the healthcare system.

A survey of pharmacists' perception of the work environment and patient safety in community pharmacies during the COVID-19 pandemic

Background

Community pharmacies have changed during the COVID-19 pandemic, and new routines have been introduced to address the needs of customers and staff and to reduce the risk of spreading infection. Burnout has been described among staff possibly due to a changed working climate. However, little research has focused on the pandemic's effect on patient safety in community pharmacies.

Objective

To examine pharmacists' perceptions of the impact of the COVID-19 pandemic on workload, working environment, and patient safety in community pharmacies.

Methods

A survey was distributed to all Swedish community pharmacists, constituting a census study. Questions regarding the pharmacists' perception of the impact of the pandemic on workload, working environment, and patient safety were included. Respondents were asked to provide comments on their working situation. Quantitative results were analysed using descriptive statistics, and comments were analysed using qualitative content analysis.

Results

The response rate was 41% (2034 responses). Most pharmacists (62%) considered the workload to be increased during the pandemic while work environment deteriorated (physical work environment was considered worse by 47% of respondents while psychosocial work environment was considered worse by 59%). Despite this, many respondents (55%) believed that patient safety was not affected. Neither having had COVID-19 nor being afraid of contracting it, influenced these perceptions in any substantial way. Findings were consistent regardless of education, professional role, number of years in community pharmacies, or special assignments in the pharmacies. According to the respondents, the communication within pharmacy companies during the pandemic was inadequate.

Conclusions

The impact of the pandemic on working conditions is in line with previous findings but the effect on patient safety needs further studies. The respondents felt the management had a limited understanding of the conditions during the pandemic, which stresses the importance of good and clear communication during a crisis.

Views on the role of community pharmacy in local communities: a case study of stakeholders' attitudes

Objectives

To investigate the view of the role of community pharmacy by selected stakeholders in local Danish communities.

Methods

A mixed method approach combining qualitative and quantitative methods was used: observations at pharmacies, questionnaires for pharmacy staff and customers, and interviews with pharmacy owners, general practitioners (GPs) and politicians. Role theory was the theoretical foundation. Data was analyzed using directed content analysis and descriptive statistics.

Results

Five Danish towns were visited, resulting in five pharmacist interviews, 48 questionnaire replies from pharmacy staff, 59 customer interviews, three GP interviews and four interviews with local politicians. All stakeholders found the pharmacy to have a medical focus, although to a differing degree. While pharmacy staff and GPs had the greatest knowledge and expectations regarding the pharmacy staff's level of medical knowledge, local politicians had the least. Pharmacy staff wanted to take on more responsibility. Customers generally considered the pharmacy part of the healthcare sector with a high level of knowledge on medications. GPs' attitudes appeared to be related to the amount of communication between GP office and pharmacy. Local politicians interviewed did not seem to be aware of the competencies within the pharmacy, but once informed were open to using the pharmacy as an integrated part of the local healthcare system.

Conclusions

There was general consensus between stakeholder groups that medicine is the main area of focus at the pharmacy. However, investigated stakeholders did not appear to be aware of the full extent of the competencies within the pharmacy, and there was a general lack of consensus about the services the pharmacy should perform. If the competencies within the pharmacy are to be fully utilized, the pharmacy must not only tell but also show the local community what they can do.