Skip to main content
Top
Published in: BMC Health Services Research 1/2024

Open Access 01-12-2024 | Research

Improving medication dispensing and counselling for patients with vision impairment: a qualitative study of pharmacist-reported barriers and facilitators

Authors: Basma Y. Kentab, Heather E. Barry, Sinaa A. Al-Aqeel, Carmel M. Hughes

Published in: BMC Health Services Research | Issue 1/2024

Login to get access

Abstract

Background

People with vision impairment encounter many difficulties when it comes to medicines use. However, evidence indicates that there are major gaps in pharmaceutical care service provision worldwide and limited research on interventions to optimise medication use for this patient population. The Theoretical Domains Framework (TDF) provides a method for theoretically understanding individuals’ behaviour and informing development of interventions. The aim of this research was to (a) identify the barriers and facilitators to the provision of medication dispensing and counselling services by pharmacists to patients with vision impairment, and (b) identify key TDF domains to be targeted in a future intervention.

Methods

Semi-structured interviews were conducted with pharmacists from different pharmacy practice settings/areas in Saudi Arabia. The 14-domain TDF was utilised as the theoretical lens through which pharmacists’ behaviours were examined. Interviews were conducted in Arabic or English, either face-to-face or over the telephone based on the participant’s preference. Following transcription, interviews conducted in Arabic were translated into English before analysis. Data analysis involved using the framework method and content analysis to identify important barriers and facilitators to the provision of dispensing and counselling services to those with vision impairment. Key TDF domains that could be targeted in a future intervention were then identified using a consensus-based approach.

Results

Twenty-six pharmacists were interviewed. Pharmacists’ experience in pharmacy practice ranged from two to 28 years. A range of barriers and facilitators were highlighted as important in providing services to those with vision impairment. Eight domains were identified as ‘key domains’ including: ‘Knowledge’, ‘Skills’, ‘Beliefs about capabilities’, ‘Goals’, ‘Memory, attention, and decision processes’, ‘Environmental context and resources’, ‘Social influences’, and ‘Behavioural regulation’.

Conclusions

Barriers and facilitators identified by pharmacists will inform the development of an intervention to ensure its applicability to everyday practice. Future research will focus on the process of developing the proposed intervention through targeting key TDF domains to improve medication dispensing and counselling by pharmacists to patients with vision impairment.
Appendix
Available only for authorised users
Literature
1.
go back to reference Tsuyuki RT, Beahm NP, Okada H, Al Hamarneh YN. Pharmacists as accessible primary health care providers: review of the evidence. Can Pharm J. 2018;151(1):4–5.CrossRef Tsuyuki RT, Beahm NP, Okada H, Al Hamarneh YN. Pharmacists as accessible primary health care providers: review of the evidence. Can Pharm J. 2018;151(1):4–5.CrossRef
2.
go back to reference Barnett N, Bushra A, Huddy H, Majekodumni F, Thomas S, Chiu F. How to support patients with sight loss in pharmacy. Pharm J. 2017;299(7904):1–8. Barnett N, Bushra A, Huddy H, Majekodumni F, Thomas S, Chiu F. How to support patients with sight loss in pharmacy. Pharm J. 2017;299(7904):1–8.
3.
go back to reference Alhusein N, Macaden L, Smith A, Stoddart KM, Taylor AJ, Killick K, Kroll T, Watson MC. “Has she seen me?”: A multiple methods study of the pharmaceutical care needs of older people with sensory impairment in Scotland. BMJ Open. 2018;8(8):e023198.CrossRefPubMedPubMedCentral Alhusein N, Macaden L, Smith A, Stoddart KM, Taylor AJ, Killick K, Kroll T, Watson MC. “Has she seen me?”: A multiple methods study of the pharmaceutical care needs of older people with sensory impairment in Scotland. BMJ Open. 2018;8(8):e023198.CrossRefPubMedPubMedCentral
4.
go back to reference Alhusein N, Killick K, Macaden L, Smith A, Stoddart K, Taylor A, Kroll T, Watson MC. “We’re really not ready for this”: a qualitative exploration of community pharmacy personnel’s perspectives on the pharmaceutical care of older people with sensory impairment. Disabil Health J. 2019;12(2):242–8.CrossRefPubMedPubMedCentral Alhusein N, Killick K, Macaden L, Smith A, Stoddart K, Taylor A, Kroll T, Watson MC. “We’re really not ready for this”: a qualitative exploration of community pharmacy personnel’s perspectives on the pharmaceutical care of older people with sensory impairment. Disabil Health J. 2019;12(2):242–8.CrossRefPubMedPubMedCentral
5.
go back to reference Lee BH, Lee YJ. Evaluation of medication use and pharmacy services for visually impaired persons: perspectives from both visually impaired and community pharmacists. Disabil Health J. 2019;12(1):79–86.CrossRefPubMed Lee BH, Lee YJ. Evaluation of medication use and pharmacy services for visually impaired persons: perspectives from both visually impaired and community pharmacists. Disabil Health J. 2019;12(1):79–86.CrossRefPubMed
6.
go back to reference Kentab BY, Barry HE, Al-Aqeel SA, Hughes CM. A systematic review of pharmacists’ interventions to support medicines optimisation in patients with visual impairment. Int J Clin Pharm. 2019;41(6):1400–7.CrossRefPubMed Kentab BY, Barry HE, Al-Aqeel SA, Hughes CM. A systematic review of pharmacists’ interventions to support medicines optimisation in patients with visual impairment. Int J Clin Pharm. 2019;41(6):1400–7.CrossRefPubMed
9.
go back to reference Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: The new medical research council guidance. BMJ. 2008;337:a1655.CrossRefPubMedPubMedCentral Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: The new medical research council guidance. BMJ. 2008;337:a1655.CrossRefPubMedPubMedCentral
10.
go back to reference Michie S, Abraham C. Interventions to change health behaviours: evidence-based or evidence-inspired? Psychol Health. 2004;19(1):29–49.CrossRef Michie S, Abraham C. Interventions to change health behaviours: evidence-based or evidence-inspired? Psychol Health. 2004;19(1):29–49.CrossRef
11.
go back to reference Rothman AJ. “Is there nothing more practical than a good theory?”: Why innovations and advances in health behavior change will arise if interventions are used to test and refine theory. Int J Behav Nutr Phys Act. 2004;1(1):11.CrossRefPubMedPubMedCentral Rothman AJ. “Is there nothing more practical than a good theory?”: Why innovations and advances in health behavior change will arise if interventions are used to test and refine theory. Int J Behav Nutr Phys Act. 2004;1(1):11.CrossRefPubMedPubMedCentral
12.
go back to reference Michie S. Designing and implementing behaviour change interventions to improve population health. J Health Serv Res Policy. 2008;13(Suppl 3):64–9.CrossRefPubMed Michie S. Designing and implementing behaviour change interventions to improve population health. J Health Serv Res Policy. 2008;13(Suppl 3):64–9.CrossRefPubMed
13.
go back to reference Dagnachew N, Meshesha SG, Mekonen ZT. A qualitative exploration of barriers in accessing community pharmacy services for persons with disability in Addis Ababa, Ethiopia: a cross sectional phenomenological study. BMC Health Serv Res. 2021;21(1):467.CrossRefPubMedPubMedCentral Dagnachew N, Meshesha SG, Mekonen ZT. A qualitative exploration of barriers in accessing community pharmacy services for persons with disability in Addis Ababa, Ethiopia: a cross sectional phenomenological study. BMC Health Serv Res. 2021;21(1):467.CrossRefPubMedPubMedCentral
14.
go back to reference Atkins L, Francis J, Islam R, O’Connor D, Patey A, Ivers N, Foy R, Duncan EM, Colquhoun H, Grimshaw JM, et al. A guide to using the theoretical domains framework of behaviour change to investigate implementation problems. Implement Sci. 2017;12(1):77.CrossRefPubMedPubMedCentral Atkins L, Francis J, Islam R, O’Connor D, Patey A, Ivers N, Foy R, Duncan EM, Colquhoun H, Grimshaw JM, et al. A guide to using the theoretical domains framework of behaviour change to investigate implementation problems. Implement Sci. 2017;12(1):77.CrossRefPubMedPubMedCentral
15.
go back to reference Michie S, Johnston M, Abraham C, Lawton R, Parker D, Walker A. Making psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care. 2005;14(1):26–33.CrossRefPubMedPubMedCentral Michie S, Johnston M, Abraham C, Lawton R, Parker D, Walker A. Making psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care. 2005;14(1):26–33.CrossRefPubMedPubMedCentral
16.
go back to reference Cane J, O’Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci. 2012;7:37.CrossRefPubMedPubMedCentral Cane J, O’Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci. 2012;7:37.CrossRefPubMedPubMedCentral
17.
go back to reference Michie S, Johnston M, Francis J, Hardeman W, Eccles M. From theory to intervention: mapping theoretically derived behavioural determinants to behaviourchange techniques. Appl Psychol. 2008;57(4):660–80.CrossRef Michie S, Johnston M, Francis J, Hardeman W, Eccles M. From theory to intervention: mapping theoretically derived behavioural determinants to behaviourchange techniques. Appl Psychol. 2008;57(4):660–80.CrossRef
18.
go back to reference Michie S, Richardson M, Johnston M, Abraham C, Francis J, Hardeman W, Eccles MP, Cane J, Wood CE. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann Behav Med. 2013;46(1):81–95.CrossRefPubMed Michie S, Richardson M, Johnston M, Abraham C, Francis J, Hardeman W, Eccles MP, Cane J, Wood CE. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann Behav Med. 2013;46(1):81–95.CrossRefPubMed
19.
go back to reference Michie S, Atkins L, West R. The behaviour change wheel: A guide to designing interventions. Great Britain: Silverback Publishing; 2014. Michie S, Atkins L, West R. The behaviour change wheel: A guide to designing interventions. Great Britain: Silverback Publishing; 2014.
20.
go back to reference Cane J, Richardson M, Johnston M, Ladha R, Michie S. From lists of behaviour change techniques (BCTs) to structured hierarchies: comparison of two methods of developing a hierarchy of BCTs. Br J Health Psychol. 2015;20(1):130–50.CrossRefPubMed Cane J, Richardson M, Johnston M, Ladha R, Michie S. From lists of behaviour change techniques (BCTs) to structured hierarchies: comparison of two methods of developing a hierarchy of BCTs. Br J Health Psychol. 2015;20(1):130–50.CrossRefPubMed
21.
go back to reference Skivington K, Matthews L, Simpson SA, Craig P, Baird J, Blazeby JM, Boyd KA, Craig N, French DP, McIntosh E, et al. A new framework for developing and evaluating complex interventions: update of medical research council guidance. BMJ. 2021;374:n2061.CrossRefPubMedPubMedCentral Skivington K, Matthews L, Simpson SA, Craig P, Baird J, Blazeby JM, Boyd KA, Craig N, French DP, McIntosh E, et al. A new framework for developing and evaluating complex interventions: update of medical research council guidance. BMJ. 2021;374:n2061.CrossRefPubMedPubMedCentral
22.
go back to reference Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57.CrossRefPubMed Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57.CrossRefPubMed
23.
go back to reference Qutub AF, Al-Jewair TS, Leake JL. A comparative study of the health care systems of Canada and Saudi Arabia: Lessons and insights. Int Dent J. 2009;59(5):277–83.PubMed Qutub AF, Al-Jewair TS, Leake JL. A comparative study of the health care systems of Canada and Saudi Arabia: Lessons and insights. Int Dent J. 2009;59(5):277–83.PubMed
24.
go back to reference Almalki M, Fitzgerald G, Clark M. Health care system in Saudi Arabia: an overview. East Mediterr Health J. 2011;17(10):784–93.CrossRefPubMed Almalki M, Fitzgerald G, Clark M. Health care system in Saudi Arabia: an overview. East Mediterr Health J. 2011;17(10):784–93.CrossRefPubMed
25.
go back to reference Cadogan CA, Ryan C, Francis JJ, Gormley GJ, Passmore P, Kerse N, Hughes CM. Improving appropriate polypharmacy for older people in primary care: Selecting components of an evidence-based intervention to target prescribing and dispensing. Implement Sci. 2015;10:161.CrossRefPubMedPubMedCentral Cadogan CA, Ryan C, Francis JJ, Gormley GJ, Passmore P, Kerse N, Hughes CM. Improving appropriate polypharmacy for older people in primary care: Selecting components of an evidence-based intervention to target prescribing and dispensing. Implement Sci. 2015;10:161.CrossRefPubMedPubMedCentral
26.
go back to reference Barry HE, Bedford LE, McGrattan M, Ryan C, Passmore AP, Robinson AL, Molloy GJ, Darcy CM, Buchanan H, Hughes CM. Improving medicines management for people with dementia in primary care: A qualitative study of healthcare professionals to develop a theory-informed intervention. BMC Health Serv Res. 2020;20(1):120.CrossRefPubMedPubMedCentral Barry HE, Bedford LE, McGrattan M, Ryan C, Passmore AP, Robinson AL, Molloy GJ, Darcy CM, Buchanan H, Hughes CM. Improving medicines management for people with dementia in primary care: A qualitative study of healthcare professionals to develop a theory-informed intervention. BMC Health Serv Res. 2020;20(1):120.CrossRefPubMedPubMedCentral
27.
go back to reference Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol. 2013;13:117.CrossRefPubMedPubMedCentral Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol. 2013;13:117.CrossRefPubMedPubMedCentral
29.
go back to reference Badreldin HA, Alosaimy S, Aljedai A. Clinical pharmacy practice in Saudi Arabia: Historical evolution and future perspective. J Am Coll Clin Pharm. 2020;3(5):920–9.CrossRef Badreldin HA, Alosaimy S, Aljedai A. Clinical pharmacy practice in Saudi Arabia: Historical evolution and future perspective. J Am Coll Clin Pharm. 2020;3(5):920–9.CrossRef
30.
go back to reference Duckett PS, Pratt R. The researched opinions on research: Visually impaired people and visual impairment research. Disabil Soc. 2001;16(6):815–35.CrossRef Duckett PS, Pratt R. The researched opinions on research: Visually impaired people and visual impairment research. Disabil Soc. 2001;16(6):815–35.CrossRef
31.
go back to reference Tang D, Dinh H, Almansour H, Burlutsky G, Bussing J, Eisenhauer B, Gopinath B, Flood VM, Saini B. Evaluation of educational interventions on eye health for dietetic and pharmacy professions: a pre-post study. BMC Med Educ. 2021;21(1):478.CrossRefPubMedPubMedCentral Tang D, Dinh H, Almansour H, Burlutsky G, Bussing J, Eisenhauer B, Gopinath B, Flood VM, Saini B. Evaluation of educational interventions on eye health for dietetic and pharmacy professions: a pre-post study. BMC Med Educ. 2021;21(1):478.CrossRefPubMedPubMedCentral
32.
go back to reference Hindi AMK, Schafheutle EI, Jacobs S. Patient and public perspectives of community pharmacies in the United Kingdom: a systematic review. Health Expect. 2018;21(2):409–28.CrossRefPubMed Hindi AMK, Schafheutle EI, Jacobs S. Patient and public perspectives of community pharmacies in the United Kingdom: a systematic review. Health Expect. 2018;21(2):409–28.CrossRefPubMed
33.
go back to reference El Hajj MS, Mekkawi R, Elkaffash R, Saleh R, El Awaisi A, Wilbur K. Public attitudes towards community pharmacy in Arabic speaking Middle Eastern countries: a systematic review. Res Social Adm Pharm. 2021;17(8):1373–95.CrossRefPubMed El Hajj MS, Mekkawi R, Elkaffash R, Saleh R, El Awaisi A, Wilbur K. Public attitudes towards community pharmacy in Arabic speaking Middle Eastern countries: a systematic review. Res Social Adm Pharm. 2021;17(8):1373–95.CrossRefPubMed
34.
go back to reference Hwang AY, Gums TH, Gums JG. The benefits of physician-pharmacist collaboration. J Fam Pract. 2017;66(12):e1–8.PubMed Hwang AY, Gums TH, Gums JG. The benefits of physician-pharmacist collaboration. J Fam Pract. 2017;66(12):e1–8.PubMed
35.
go back to reference Cromer J, Hojjat R, Peker S, Aprile J. Fostering the pharmacist-physician relationship. Am J Health Syst Pharm. 2009;66(2):118–9.CrossRefPubMed Cromer J, Hojjat R, Peker S, Aprile J. Fostering the pharmacist-physician relationship. Am J Health Syst Pharm. 2009;66(2):118–9.CrossRefPubMed
36.
go back to reference AlRuthia Y, Alsenaidy MA, Alrabiah HK, AlMuhaisen A, Alshehri M. The status of licensed pharmacy workforce in Saudi Arabia: A 2030 economic vision perspective. Hum Resour Health. 2018;16(1):28.CrossRefPubMedPubMedCentral AlRuthia Y, Alsenaidy MA, Alrabiah HK, AlMuhaisen A, Alshehri M. The status of licensed pharmacy workforce in Saudi Arabia: A 2030 economic vision perspective. Hum Resour Health. 2018;16(1):28.CrossRefPubMedPubMedCentral
37.
go back to reference Balkhi B, Alghamdi A, Alhossan A, Alhamami A, Asiri YA. Pharmacy students attitude and perception toward working in community pharmacy in Saudi Arabia. Saudi Pharm J. 2020;28(4):397–402.CrossRefPubMedPubMedCentral Balkhi B, Alghamdi A, Alhossan A, Alhamami A, Asiri YA. Pharmacy students attitude and perception toward working in community pharmacy in Saudi Arabia. Saudi Pharm J. 2020;28(4):397–402.CrossRefPubMedPubMedCentral
Metadata
Title
Improving medication dispensing and counselling for patients with vision impairment: a qualitative study of pharmacist-reported barriers and facilitators
Authors
Basma Y. Kentab
Heather E. Barry
Sinaa A. Al-Aqeel
Carmel M. Hughes
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2024
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-024-11009-9

Other articles of this Issue 1/2024

BMC Health Services Research 1/2024 Go to the issue