Counselling behaviour and content in a pharmaceutical care service in Swedish community pharmacies

Objective To characterise the counselling behaviour of practitioners providing a pharmaceutical care (PC) service in community pharmacy, and to describe the content of the consultations. Setting Community pharmacies in Sweden. Methods Non-participant observations, including audio recording, of five practitioners in five different pharmacies counselling 16 patients, were analysed qualitatively using an iterative, stepwise, interpretivist approach. Main outcome measure Descriptions of counselling behaviour and content of consultations. Results The counselling behaviour was characterised by attempts to understand the patients’ narratives by listening and asking questions and a willingness to help. The computer often had an important role in consultations, being used for documentation and as a supportive tool for identification of drug–drug interactions. The practitioners often took command in the initial phase of the consultation, and omitted to determine the patients’ most urgent drug-related needs. However, counselling behaviour that identified and focused on the patient’s needs, giving the computer little attention during the consultation was also observed. Practitioners provided vague descriptions of the purpose and outline of the service. Consultations included a wide variety of issues, which potentially could help patients’ achieve optimal outcomes of medical treatment. Conclusion The practitioners provided important advice and different forms of support to patients. Focus on the computer screen limited their abilities to practise patient centred care.