Understanding public trust in services provided by community pharmacists relative to those provided by general practitioners: a qualitative study

作者：Gidman Wendy^*; Ward Paul; McGregor Lesley

来源：BMJ Open, 2012, 2(3): e000939.

DOI：10.1136/bmjopen-2012-000939

Objectives: To apply sociological theories to understand public trust in extended services provided by community pharmacists relative to those provided by general practitioners (GPs). %26lt;br%26gt;Design: Qualitative study involving focus groups with members of the public. %26lt;br%26gt;Setting: The West of Scotland. %26lt;br%26gt;Participants: 26 purposively sampled members of the public were involved in one of five focus groups. The groups were composed to represent known groups of users and non-users of community pharmacy, namely mothers with young children, seniors and men. %26lt;br%26gt;Results: Trust was seen as being crucial in healthcare settings. Focus group discussions revealed that participants were inclined to draw unfavourable comparisons between pharmacists and GPs. Importantly, participants%26apos; trust in GPs was greater than that in pharmacists. Participants considered pharmacists to be primarily involved in medicine supply, and awareness of the pharmacist%26apos;s extended role was low. Participants were often reluctant to trust pharmacists to deliver unfamiliar services, particularly those perceived to be %26apos;high risk%26apos;. Numerous system-based factors were identified, which reinforce patient trust and confidence in GPs, including GP registration and appointment systems, GPs%26apos; expert/gatekeeper role and practice environments. Our data indicate that the nature and context of public interactions with GPs fostered familiarity with a specific GP or practice, which allowed interpersonal trust to develop. By contrast, participants%26apos; exposure to community pharmacists was limited. Additionally, a good understanding of the GPs%26apos; level of training and role promoted confidence. %26lt;br%26gt;Conclusion: Current UK initiatives, which aim to implement a range of pharmacist-led services, are undermined by lack of public trust. It seems improbable that the public will trust pharmacists to deliver unfamiliar services, which are perceived to be %26apos;high risk%26apos;, unless health systems change in a way that promotes trust in pharmacists. This may be achieved by increasing the quality and quantity of patient interactions with pharmacists and gaining GP support for extended pharmacy services.

• 出版日期2012