Pharmaceutical care uncovered: An ethnographic study of pharmaceutical care practice

For the pharmacy profession to reach a deeper understanding of human phenomena, it needs to enter into and learn about the world in which we live as human beings, taking into consideration human experience as it is lived in social, cultural, historical, and political contexts. This study explored patients, practitioners and students' experiences within the historic-socio-cultural context of the promising pharmacy practice model known as pharmaceutical care. Pharmaceutical care is a practice that addresses individual patients' medication-related needs and society's problem of harm resulting from medications. The pharmaceutical care practitioner works directly with patients to ensure that their drug therapy is needed, effective, safe and convenient. An ethnographic study was conducted for eight months in nine clinics and one community pharmacy in the Twin Cities. Field observation, in-depth interviews, focus groups, and analysis of documents were conducted in order to uncover the practice as it is in the real world. Twenty-five patients, thirteen pharmaceutical care practitioners and ten pharmacy students participated in the project. The results of this project unveiled patients' experiences with and their thoughts about the service of pharmaceutical care. Additionally, the results disclosed the management structure, delivery of the service and the apparent gaps within the health care organizations' provision of pharmaceutical care. The results uncovered the skills and knowledge required to be a patient-centered practitioner as well as provided an understanding of how to better prepare students for this role. Though this study was for a doctoral dissertation, the findings were of grave import to the health care organization and were subsequently presented to the practitioners, managers and decision-makers. The findings portrayed for practitioners what patients valued about the practice, what they desired from health care professionals and health care, and what they needed with regards to their medications. Furthermore, the study provided essential information for managers to make educated decisions about the service in order to better meet patients' needs. Lastly, this study was a crucial step in moving the pharmacy profession towards a more caring practice to better meet the medication-related needs of patients and serve a unique and vital role in society.