Management of medicines in chronic illness: views of community pharmacists in New South Wales

Background: Healthcare reforms are needed to meet the predicted increase in the chronic disease burden. A multidisciplinary team approach has been extensively evaluated and shown to improve health outcomes. There is also support for including pharmacists in these teams. Pharmacists have valuable insight, from a medication perspective, to improve the management of patients with chronic illness. Aim: To explore the perceptions of community pharmacists regarding the incentives, barriers and solutions in managing the medication regimens of patients with chronic illness. Method: Semi-structured group discussions and individual interviews were conducted in October and November 2008 with community pharmacists working in Western Sydney and the Blue Mountains. Results: Community pharmacists struggle to provide optimal care for patients with chronic illness. Identified reasons include poor communication with patients and health professionals, lack of care coordination and continuity of care. Many patients were thought to struggle financially when managing a chronic illness, which negatively influenced their adherence to medication regimens and recommendations on lifestyle changes. Better teamwork and communication, possibly through co-locating health professionals under one roof were suggested by pharmacists as possible solutions. Conclusion: Pharmacists have a good understanding of patients' social circumstances but lack relevant clinical data. Community pharmacists are willing to take a greater role in the management of patients with chronic illness.