Roles of medicines counter assistants in advice giving in community pharmacies: a Discourse Analysis

Objective Research in interaction and communication in community pharmacies has been reported in a number of countries but to date, talk at the micro-level in the community pharmacy context in the UK has received virtually no study. The objective of this exploratory study was to identify what light a Discourse Analytic approach could shed to describe the role(s) of Medicines Counter Assistants (MCAs) when dealing with clients relating to health, illness or medicines. Methods Discourse Analysis is a growing field of study which has its roots in linguistics, but also in critical theory, philosophy, sociology, psychology and more. It is used in various ways by social scientists studying spoken and written language in use. Following research ethics approval and informed consent from participants, audio-recordings of staff–client interactions in three community pharmacies in Wales, UK were transcribed and analysed from a Discourse Analytic perspective, focussing on the emerging role of the MCA in the negotiation of advice. Main outcome measure Transcripts of interactions in community pharmacies analysed using Discourse Analysis. Results Ten hours of recordings were made. Of the 41 recorded interactions obtained, 29 involved an MCA regarding health and/or medicines. Example extracts represent different ways in which MCAs are involved in the interactions, ranging from dealing solely with the client, to the MCA dealing with the client but checking advice with the pharmacist, the MCA acting as a gatekeeper, the pharmacist intervening in the MCA–client interaction, the MCA keeping the client ‘on hold’ until the pharmacist is ready to interact with them and the MCA acting as an active intermediary. With the differing involvement, slightly different institutional and participant roles emerge for the MCAs through talk and interaction. Conclusion This exploratory study succeeded in producing transcripts of interactions between MCAs, and clients and indicated that Discourse Analysis is helpful in assisting our understanding of the involvement of MCAs in UK community pharmacy encounters. With regards the negotiation of advice, we have shown how the physical and legal contexts, in addition to the discursive/interactional context, play a part in information delivery, as does the different staff’s access to knowledge.