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Community pharmacists’ views about prescription medicine co-payments and potential implications for equitable access to medicines: a critical realist interpretation

BACKGROUND: In many countries the community pharmacist’s role includes collecting prescription medicine co-payments at the point of dispensing. This is a context which can provide unique insights into individuals’ access to prescription medicines, as interactions with service users about out-of-pock...

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Autores principales: Peacocke, Elizabeth F., Fusheini, Adam, Norris, Pauline
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10680315/
https://www.ncbi.nlm.nih.gov/pubmed/38012721
http://dx.doi.org/10.1186/s40545-023-00673-7
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author Peacocke, Elizabeth F.
Fusheini, Adam
Norris, Pauline
author_facet Peacocke, Elizabeth F.
Fusheini, Adam
Norris, Pauline
author_sort Peacocke, Elizabeth F.
collection PubMed
description BACKGROUND: In many countries the community pharmacist’s role includes collecting prescription medicine co-payments at the point of dispensing. This is a context which can provide unique insights into individuals’ access to prescription medicines, as interactions with service users about out-of-pocket (OOP) expenses that may negatively affect a pharmacist’s patient counselling role. Prior research has identified that OOP expenses for prescription medicines led to decreased treatment adherence. This study aims to understand the role of community pharmacists in the collection of co-payments for prescription medicines in one region of Aotearoa New Zealand, and the possible implications for equitable access to medicines. METHODS: This is a qualitative study using a case study research design. Data were collected through focus groups, individual interviews, and an electronic survey. Using a critical realist approach in thematic analysis, findings were categorised as Causal tendencies (the things that cause the events); Events (the things that community pharmacists experience); and Experiences (the perceptions and feelings of individual participants). RESULTS: Our analysis finds that the current profession of community pharmacy in Aotearoa New Zealand, is under strain. The results suggest that broader government policies, such as the pharmacist’s role in delivering essential health services, the fairness of standard prescription co-payments, and the role of community pharmacists as gatekeepers, have a significant influence on the profession. In addition, the study found that individual community pharmacists have a unique position in the co-payment process, face power imbalances within their role, and the study indicates evidence of value judgements towards service users. CONCLUSIONS: This study is exploratory; however, its examination of the policy of prescription medicine co-payments from the perspective of community pharmacists, who play a vital role in both dispensing medicines and collecting prescription medicine co-payments, is novel. Despite prescription medicine co-payments being a routine part of pharmacists’ role in many countries, it is a topic where there is limited published peer-reviewed literature. The study adds to existing evidence that funding models influence community pharmacists’ role. In addition, this study identified value judgements about service users in relation to prescription medicine co-payments which may influence service users’ health-seeking behaviour. In this setting, limited representation of at-risk populations in the community pharmacy profession may be a factor that negatively influence interactions between pharmacists and service users.
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spelling pubmed-106803152023-11-27 Community pharmacists’ views about prescription medicine co-payments and potential implications for equitable access to medicines: a critical realist interpretation Peacocke, Elizabeth F. Fusheini, Adam Norris, Pauline J Pharm Policy Pract Research BACKGROUND: In many countries the community pharmacist’s role includes collecting prescription medicine co-payments at the point of dispensing. This is a context which can provide unique insights into individuals’ access to prescription medicines, as interactions with service users about out-of-pocket (OOP) expenses that may negatively affect a pharmacist’s patient counselling role. Prior research has identified that OOP expenses for prescription medicines led to decreased treatment adherence. This study aims to understand the role of community pharmacists in the collection of co-payments for prescription medicines in one region of Aotearoa New Zealand, and the possible implications for equitable access to medicines. METHODS: This is a qualitative study using a case study research design. Data were collected through focus groups, individual interviews, and an electronic survey. Using a critical realist approach in thematic analysis, findings were categorised as Causal tendencies (the things that cause the events); Events (the things that community pharmacists experience); and Experiences (the perceptions and feelings of individual participants). RESULTS: Our analysis finds that the current profession of community pharmacy in Aotearoa New Zealand, is under strain. The results suggest that broader government policies, such as the pharmacist’s role in delivering essential health services, the fairness of standard prescription co-payments, and the role of community pharmacists as gatekeepers, have a significant influence on the profession. In addition, the study found that individual community pharmacists have a unique position in the co-payment process, face power imbalances within their role, and the study indicates evidence of value judgements towards service users. CONCLUSIONS: This study is exploratory; however, its examination of the policy of prescription medicine co-payments from the perspective of community pharmacists, who play a vital role in both dispensing medicines and collecting prescription medicine co-payments, is novel. Despite prescription medicine co-payments being a routine part of pharmacists’ role in many countries, it is a topic where there is limited published peer-reviewed literature. The study adds to existing evidence that funding models influence community pharmacists’ role. In addition, this study identified value judgements about service users in relation to prescription medicine co-payments which may influence service users’ health-seeking behaviour. In this setting, limited representation of at-risk populations in the community pharmacy profession may be a factor that negatively influence interactions between pharmacists and service users. BioMed Central 2023-11-27 /pmc/articles/PMC10680315/ /pubmed/38012721 http://dx.doi.org/10.1186/s40545-023-00673-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Peacocke, Elizabeth F.
Fusheini, Adam
Norris, Pauline
Community pharmacists’ views about prescription medicine co-payments and potential implications for equitable access to medicines: a critical realist interpretation
title Community pharmacists’ views about prescription medicine co-payments and potential implications for equitable access to medicines: a critical realist interpretation
title_full Community pharmacists’ views about prescription medicine co-payments and potential implications for equitable access to medicines: a critical realist interpretation
title_fullStr Community pharmacists’ views about prescription medicine co-payments and potential implications for equitable access to medicines: a critical realist interpretation
title_full_unstemmed Community pharmacists’ views about prescription medicine co-payments and potential implications for equitable access to medicines: a critical realist interpretation
title_short Community pharmacists’ views about prescription medicine co-payments and potential implications for equitable access to medicines: a critical realist interpretation
title_sort community pharmacists’ views about prescription medicine co-payments and potential implications for equitable access to medicines: a critical realist interpretation
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10680315/
https://www.ncbi.nlm.nih.gov/pubmed/38012721
http://dx.doi.org/10.1186/s40545-023-00673-7
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