Objective To describe common facilitators, challenges, and lessons learned in 5 schools and colleges of pharmacy in establishing community pharmacy research fellowships. Setting: Five schools and colleges of pharmacy in the United States. Practice description: Schools and colleges of pharmacy with existing community partnerships identified a need and ability to develop opportunities for pharmacists to engage in advanced research training. Practice innovation: Community pharmacy fellowships, each structured as 2 years long and in combination with graduate coursework, have been established at the University of Pittsburgh, Purdue University, East Tennessee State University, University of North Carolina at Chapel Hill, and The Ohio State University. Evaluation: Program directors from each of the 5 community pharmacy research fellowships identified common themes pertaining to program structure, outcomes, and lessons learned to assist others planning similar programs. Results: Common characteristics across the programs include length of training, prerequisites, graduate coursework, mentoring structure, and immersion into a pharmacist patient care practice. Common facilitators have been the existence of strong community pharmacy partnerships, creating a fellowship advisory team, and networking. A common challenge has been recruitment, with many programs experiencing at least one year without filling the fellowship position. All program graduates (n = 4) have been successful in securing pharmacy faculty positions. Conclusion: Five schools and colleges of pharmacy share similar experiences in implementing community pharmacy research fellowships. Early outcomes show promise for this training pathway in growing future pharmacist-scientists focused on community pharmacy practice.

Desde a época do Brasil colônia até aproximadamente 1930, os farmacêuticos atuavam basicamente em farmácias conhecidas como Boticas. Esses estabelecimentos preparavam, armazenavam, vendiam e até forneciam prescrições de medicamentos e nessa época, o farmacêutico era reconhecido pela sociedade como o profissional do medicamento. Após a segunda guerra mundial com o advento da indústria farmacêutica, o medicamento artesanal foi substituído pelo industrializado e o farmacêutico perdeu gradativamente a sua função principal na saúde: a produção do medicamento. Nesse cenário, uma pequena parte da mão de obra farmacêutica foi inserida na indústria farmacêutica, porém, a grande parte desses profissionais foi inserida na farmácia e precisou disputar a venda de medicamentos com profissionais sem formação acadêmica que trabalhavam nesses estabelecimentos. A dispensação de medicamentos é considerada uma atividade privativa a profissionais farmacêuticos, porém no Brasil essa atividade é realizada em grande parte por leigos e de maneira inapropriada. O presente estudo visa mensurar a importância da educação formal, aliado à prática, para a dispensação do medicamento por meio da aplicação de instrumento de estudo que mensura o conhecimento sobre dispensação do medicamento nos profissionais envolvidos nessa prática (farmacêutico, técnico em farmácia e balconista/prático e estudante egresso do curso de técnico em farmácia). O estudo foi dividido em duas fases; a fase A possui delineamento metodológico e caracteriza-se pela elaboração e validação de um instrumento para mensurar o conhecimento sobre dispensação; enquanto a fase B possui delineamento transversal e foi aplicado tal instrumento nos profissionais oriundos de 105 farmácias da região de Orlândia/SP e Batatais/SP bem como nos estudantes egressos dos cursos de técnico em farmácia oferecidos nessas regiões. Foi elaborado um questionário denominado CDM-51 e dividido em duas partes: a primeira coleta as características sociodemográficas dos participantes e a segunda possui 51 questões para avaliar o construto conhecimento sobre dispensação. A validade de face e conteúdo foi realizada por meio da avaliação por sete especialistas quanto à pertinência e a clareza dos itens. Conduziu-se um pré-teste e um estudo principal da validação com respectivamente, 30 e 79 profissionais de farmácias do munícipio de Ribeirão Preto/SP e as dúvidas que os respondentes apresentaram foram corrigidas; na análise da consistência interna o KR 20 foi de 0,837, na validade de construto encontraram-se evidências (valor p=0,001) de que participantes com educação formal têm maior conhecimento sobre dispensação do medicamento. Na fase B participaram do estudo 75 farmacêuticos, 49 balconistas, 22 técnicos em farmácia e 131 estudantes egressos do curso de técnico em farmácia; a maioria são mulheres (71,12%), com idade média de 29,16 anos. Os farmacêuticos obtiveram maior conhecimento sobre dispensação do medicamento (valor p=0,001) em comparação aos demais profissionais participantes. O técnico em farmácia possui conhecimento importante sobre dispensação do medicamento em comparação aos balconistas ou \"práticos\". Este trabalho contribui para o aumento da qualidade dos serviços de dispensação prestados pelas farmácias comunitárias, pois salienta a importância da capacitação por educação formal para a realização desse serviço, proporcionando dessa maneira, o uso racional dos medicamentos / Since the time of colonial Brazil until about 1930, pharmacists worked in pharmacies basically known as Boticas. These establishments prepared, stored, sold and provided to prescriptions drugs and this time, the pharmacist was recognized by society as professional medicine. After Second World War with the advent of the pharmaceutical industry, the craft product has been replaced by industrial and pharmaceutical gradually lost its primary role in health: the production of the drug. In this scenario, a small part of pharmaceutical manpower was inserted in the pharmaceutical industry, however, many of these professionals were inserted in the pharmacy and had to compete in the sale of drugs with professional without formal education working in these establishments. The dispensation of medicines is considered a private activity for pharmaceutical professionals, but in Brazil this activity is performed largely by lay people and in an inappropriate way. This study aims to measure the importance of formal education, coupled with the practice of dispensing the drug through the application of study instrument that measures the knowledge of dispensing of the drug in the professionals involved in this practice (pharmacist, pharmacy technician in pharmacy and clerk / practical and egress student technical course in pharmacy). The study was divided in two phases; phase A has methodological design and is characterized by the development and validation of an instrument to measure the knowledge of dispensation; while phase B and has cross-sectional design such an instrument is applied in 105 professionals from pharmacies in the region of Orlândia/SP and Batatais/SP and as well as in the graduating students in pharmacy technician courses offered in these regions. A questionnaire denominated CDM-51 was elaborated and divided in two parts: the first collects the sociodemographic characteristics of the participants and the second has 51 questions to assess the construct knowledge about dispensation. The validity of face and content was realized through the evaluation by seven experts regarding the relevance and clarity of the items. It carried out a pretest and the main validation study with respectively 30 and 79 pharmacy professional from the city of Ribeirão Preto/SP and questions presented to respondents were corrected. The analysis of the internal consistency of the KR 20 was 0.837, the construct validity evidence was found (p valor: 0.001) that participants with formal education have greater knowledge of dispensing the drug. In phase B participated in the study 75 pharmacists, 49 clerks, 22 pharmacy technicians and 131 students graduating from a technical course in pharmacy; the majority are women (71.12%), with a mean age of 29.16 years. Pharmacists had greater knowledge about drug dispensing (p valor: 0.001) compared to other participating professional. The pharmacy technician has important knowledge about dispensing the drug in comparison to the clerks or \"practitioners\". This work contributes to increasing the quality of services provided by dispensing pharmacies as points out the importance of training for formal education to perform this service, providing this way, the rational use of medicines.

<p>Most patients are non-adherent with their medication sometimes, i.e. that they do not always use their medicines as prescribed. This might result in both under- and overuse and can lead to therapy failure, resulting in both unnecessary suffering and high costs. Therefore, medication adherence should be as high as possible. </p><p>The aims of this thesis were to investigate the refill adherence to long-term drug treatment, especially for patients with asthma and chronic obstructive pulmonary disease (COPD), and to study treatment gaps for patients with undersupply and drug costs for patients with oversupply. Further aims were to compare different methods for assessing refill adherence and analyse whether the same patient has the same refill adherence pattern to two different chronic drug treatments, i.e. diabetes and asthma/COPD. </p><p>The thesis shows that satisfactory refill adherence (80-120% of the prescribed dose) was 57% for repeat prescriptions with long-term drug treatment; undersupply was 21% and oversupply 22%. Patients with undersupply were without drugs more than half of the prescribed treatment time and the median oversupply for 90-100 days dispensation interval was 28 days. Patients who were exempt from charges had significantly higher oversupply than non-exempt patients and that leads to unnecessary cost for society. The level of satisfactory refill adherence for repeat prescriptions dispensed for asthma/COPD was on average 30%. The same low level was displayed for the elderly, where undersupply was more common than oversupply. </p><p>Assessments of refill adherence during a one-year period gave the same results irrespective of whether the repeat prescriptions were from an individual pharmacy record database or were manually collected at a pharmacy.</p><p>Patients with concomitant use of diabetes and asthma/COPD drugs do not have the same dispensation pattern for both drug types. </p><p>The introduction of patient profiles as a new approach to complement the calculated refill adherence needs to be further studied in larger and more divergent populations. In the future, the new national pharmacy record database in Sweden has opened up for larger studies and will be valuable when studying patterns of drug utilization.</p>

Most patients are non-adherent with their medication sometimes, i.e. that they do not always use their medicines as prescribed. This might result in both under- and overuse and can lead to therapy failure, resulting in both unnecessary suffering and high costs. Therefore, medication adherence should be as high as possible. The aims of this thesis were to investigate the refill adherence to long-term drug treatment, especially for patients with asthma and chronic obstructive pulmonary disease (COPD), and to study treatment gaps for patients with undersupply and drug costs for patients with oversupply. Further aims were to compare different methods for assessing refill adherence and analyse whether the same patient has the same refill adherence pattern to two different chronic drug treatments, i.e. diabetes and asthma/COPD. The thesis shows that satisfactory refill adherence (80-120% of the prescribed dose) was 57% for repeat prescriptions with long-term drug treatment; undersupply was 21% and oversupply 22%. Patients with undersupply were without drugs more than half of the prescribed treatment time and the median oversupply for 90-100 days dispensation interval was 28 days. Patients who were exempt from charges had significantly higher oversupply than non-exempt patients and that leads to unnecessary cost for society. The level of satisfactory refill adherence for repeat prescriptions dispensed for asthma/COPD was on average 30%. The same low level was displayed for the elderly, where undersupply was more common than oversupply. Assessments of refill adherence during a one-year period gave the same results irrespective of whether the repeat prescriptions were from an individual pharmacy record database or were manually collected at a pharmacy. Patients with concomitant use of diabetes and asthma/COPD drugs do not have the same dispensation pattern for both drug types. The introduction of patient profiles as a new approach to complement the calculated refill adherence needs to be further studied in larger and more divergent populations. In the future, the new national pharmacy record database in Sweden has opened up for larger studies and will be valuable when studying patterns of drug utilization.

Abstract This research aims to study the current situation of the community pharmacists¡¦ services, such as the collaboration mode with hospitals and medical institutes corresponding to the ¡§Separation of Prescribing and Dispensing¡¨ (Separation of P&D) in Taiwan and prescription dispensing policies, the service orientation, and the operation results in Kaohsiung City, where the Separation of P&D was implemented as early as March 1997. Furthermore, this research also aims to understand the cognition of the community pharmacists upon Pharmaceutical Services and their service orientation. It was discovered from 67 effective samples that the amount of prescriptions dispensed to those registered National Health Insurance (NHI) pharmacies were still few, hence the current situation of Separation of P&D is not that satisfying. In addition, the amount of prescriptions dispensed to community pharmacies joining the NHI were significantly more than those who did not join. Moreover, as far as for those registered NHI pharmacies collaborating with hospitals and medical institutes are concerned, the opportunity for them to receive prescriptions is far from those registered NHI pharmacies that did not collaborate with hospitals and medical institutes. The amount of prescriptions dispensed has a significant and positive correlation to the increasing of pharmacy business. In light of this, it can be said that the collaboration mode between registered NHI pharmacies and hospitals and medical institutes helps with the implementation of the Separation of P&D. The cognition of pharmacist¡¦s practicing can be divided into five categories according to factor analysis, and they are; ¡§Health Maintaining¡¨, ¡§Health Enhancing¡¨, ¡§Pharmaceutical Professional Service¡¨, ¡§Pharmaceuticals Management ¡¨, and ¡§Specialists Consultation¡¨. This research discovered that when the practicing credential is a pharmacist instead of pharmaceutical student, the service cognition on health maintaining, health enhancing, pharmaceutical professional service, and specialist¡¦s consultation were significantly different. The cognition of a pharmacist upon health enhancing and pharmaceuticals control showed significant and positive correlation to his/her business volume. Although the Separation of P&D has been implemented for over six years, and most of the regions in this country have conformed to the P&D separation regulations and the business has been carried out, the outcomes have not met the expectation, and the medicine circle alone cannot solve such problem. It needs a comprehensive consideration and review to effectively implement the existing policies.

Anecdotal descriptions and small studies have reported decreasing reimbursements from Medicare Part D sponsors and commercial third-party payers, resulting in decreased gross margins for independent pharmacies; however, reports are inconclusive regarding which payer more greatly affects independent pharmacies’ financial viability. Using 2006-2009 prescription claims data collected by a pharmacy switching company, the purpose of this study was to calculate and describe estimated reimbursement formulas and mean gross margins to assess the relative impact of these two payer groups. The study evaluated a total of 2,929,696 prescription claims paid for by Medicare Part D sponsors (n = 1,830,896) and commercial third-party payers (n = 1,098,800). The prescriptions were dispensed by 418 Texas independent pharmacies to 192,968 patients aged 65 to 94. Between 2008 and 2009, the median ingredient reimbursement ranged from AWP-17% to AWP-15% for Part D sponsors and from AWP-17.44% to AWP-15% for commercial third-party payers. The median dispensing fee ranged from $1.50 to $2.00 for Part D sponsors and from $1.10 to $2.00 for commercial third-party payers. For all payers, the median dispensing fee and median ingredient reimbursement decreased or was stagnant. Similarly, aggregate percent gross margin (calculated using the payers’ estimates of acquisition cost) decreased for both payer types between 2007 and 2009, with the mean gross margin of 4.0 percent earned for Part D prescriptions being higher than the 3.7 percent earned for commercial third-party prescriptions. In the same timeframe, the mean aggregate percent gross margin ranged from 2.8 percent to 6.0 percent among the five most popular Part D sponsors in the sample, and from 2.4 percent to 5.1 percent among the five most popular commercial third-party payers. The generic dispensing ratio explained a portion of the variance between and among payers. This study shows that significant variation exists in reimbursement formulas and percent gross margin between and among several of the most popular Part D sponsors and commercial third-party payers and supports pharmacy assertions that reimbursements from both payer types are decreasing. Pharmacies can respond to these pressures by being more conscientious of their business’ margins when reviewing contracts and increasing the proportion of generic drugs dispensed. / text

Šis tyrimas biomedicinos mokslui pateikia naujų duomenų apie galimybes ir pasiruošimą teikti vieną iš sveikatos priežiūros sistemos paslaugų – farmacinę paslaugą. Darbo tikslas – atskleisti farmacinės paslaugos sampratą ir prielaidas sociumo kaitos kontekste ir, remiantis farmacijos specialistų požiūriu bei pacientų lūkesčiais, pateikti rekomendacijas farmacinei paslaugai tobulinti. Darbe tiriama farmacinės paslaugos prielaidos ir samprata, remiantis Lietuvos farmacinę veiklą reglamentuojančiais norminiais aktais. Teoriniu atžvilgiu tyrime atskleistas farmacinės paslaugos daugiamatiškumas, principai ir funkcijos praplečia požiūrį į farmacijos specialistą, kuris, teikdamas farmacinę paslaugą, atlieka plačias socialines, taip pat ir sveikatos priežiūros specialisto funkcijas. Išanalizavus problemas, su kuriomis susiduria farmacijos specialistai, teikdami farmacinę paslaugą, ir įvertinus veiksnių, mažinančių galimybes suteikti pilnavertę paslaugą, įtaką, pateikiamos rekomendacijos, kurių įgyvendinimas padėtų tobulinti farmacijos specialistų veiklą. Pacientų lūkesčių ir farmacijos specialistų nuomonės analizė sudaro sąlygas įvertinti priežastis ir numatyti modelius, kaip užtikrinti tinkamą tarpusavio bendradarbiavimą, lemiantį gerą farmacinės paslaugos kokybę. / The sociologic data from the study showed the possibility and readiness to introduce the pharmacy service as a part of the health care services. The aim of this research was to develop the concept of, and preconditions for, the pharmacy service in the context of the social changes, and to offer recommendations for the improvement of the service, according to the attitudes of pharmaceutical specialists and expectations of patients. Preconditions for, and the concept of, the pharmacy service are analyzed in the context of the modern pharmacy regulations of the Republic of Lithuania, which has not yet been done in other research works. The theoretical analysis discloses the multidimensionality, the fundamentals and functions of the pharmacy service and creates a comprehensive view of the pharmaceutical specialist who performs multiple social and health care functions while providing the pharmacy service. Based on the analysis of problems occurring in the pharmacist’s work as well as on the evaluation of factors influencing the provision of a high-quality pharmacy service, recommendations are given in this work, which may improve the quality of pharmacists’ activities. Research findings may help to adjust the pharmaceutical specialists’ education programmes, develop a strategy for avoidance of internal and external barriers in the pharmacy sector, improve the pharmacy service and make it more accessible to the public.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Objective: To describe the studies on the working process during the practice of pharmacist dispensing. Methods: Three systematic reviews the following steps were performed accordingly: (1) identification of studies in the following databases: PubMed / Medline, Web of Science, Scopus, and Lilacs, using the descriptors ''counseling'', ''dispensing'', ''community pharmacy services'',' ''pharmacies'' and ''pharmacists'' and its synonyms with different combinations; (2) evaluation studies, in which the title and summary were eligible, according to the following inclusion criteria: studies were conducted in community pharmacies, studies on the working process in the practice of pharmaceutical dispensing and articles published in English, Portuguese or Spanish. (3) Full Text evaluation according to the following inclusion criteria: - 1st Systematic Review: The aim of this review was to understand the process of work and the quality indicators used in the Dispensation. Thus, we had the following inclusion criteria: studies with quality indicators in the dispensing work process; - 2nd Systematic Review: this review aimed to identify the questions and instructions given by the pharmacist and propose a model of practice for dispensing. Therefore, he presented as specific inclusion criteria: studies that have questions and/ or guidelines in the work process in the practice of pharmaceutical dispensing; - 3rd Systematic Review: whose objective was to evaluate the studies documenting the work process in the practice of pharmaceutical dispensing. Therefore, we had the specific inclusion criteria: studies that addressed the documentation of the work process in the practice of pharmaceutical dispensing. When there were differences between the two evaluators, a third evaluator examined and judged discrepancies in each systematic review. The databases were reviewed until September 02, 2015. Results: - In the first systematic review included 60 articles. The studies showed high heterogeneity indicating the lack of standardization of the practice of pharmaceutical dispensing work process. It was found that the quality of the tools used to evaluate the dispensing work process was not often assessed. Nine quality indicators in practice dispensing work process were found. - In the second systematic review articles 65 were included, with most studies used the method of Simulated patient, with most patients showing a passive behavior. by were listed and quantified the most common questions and instructions given pharmacists as: identification and clinical condition of the patient, indication, dose and effect of the drug, allergy, duration of treatment, adverse effects, drug interactions, non-pharmacological treatments and referral to the doctor. - In the third systematic review were included 26 articles. Few studies have addressed the documentation as part of the dispensing work process and most documented by non-computerized instruments. Conclusion: Studies on pharmaceutical dispensing should be standardized, which will facilitate the comparison of results and measure the working process of this service. Protocols, algorithms and practical documentation are needed to guide, standardize the work process of dispensing and measuring the impact of interventions by community pharmacists in patient care. / Objetivo: descrever os estudos publicados sobre o processo de trabalho durante a prática da dispensação farmacêutica. Métodos: Três revisões sistemáticas foram realizadas de acordo as seguintes etapas: (1) identificação de estudos nas seguintes bases de dados: PubMed/ Medline, Web of Science, Scopus e Lilacs, usando os descritores ‘‘counseling”, ‘‘dispensing”, ‘‘community pharmacy services’’, ‘‘pharmacies’’ and ‘‘pharmacists’’ e seus sinônimos com diferentes combinações; (2) avaliação de estudos, no qual o título e resumo foram elegíveis, de acordo com as seguintes critérios de inclusão: estudos serem conduzidos em farmácias comunitárias, estudos sobre o processo de trabalho na prática da dispensação farmacêutica e artigos publicados em inglês, português ou espanhol. (3) avaliação do texto completo de acordo com os critérios de inclusão a seguir: - 1ª Revisão Sistemática: o objetivo desta revisão foi conhecer o processo de trabalho e os indicadores de qualidade utilizados na Dispensação. Assim, teve-se como critérios de inclusão: estudos com indicadores de qualidade no processo de trabalho da Dispensação; - 2ª Revisão Sistemática: esta revisão visou Identificar as perguntas e orientações realizadas pelo farmacêutico e propor um modelo de prática para a dispensação. Logo, apresentou-se como critérios de inclusão específicos: estudos que tiveram perguntas e/ou orientações no processo de trabalho na prática da dispensação farmacêutica; - 3ª Revisão Sistemática: cujo objetivo foi avaliar os estudos que documentaram o processo de trabalho na prática da dispensação farmacêutica. Portanto, teve-se como critério de inclusão específico: estudos que abordaram a documentação no processo de trabalho na prática da dispensação farmacêutica. Quando ocorreram divergências entre os dois avaliadores, um terceiro avaliador analisou e julgou as discrepâncias em cada revisão sistemática. As bases de dados foram revisadas até 02 de setembro de 2015. Resultados: - Na primeira revisão sistemática foram incluídos 60 artigos. Os estudos apresentaram alta heterogeneidade indicando a falta de padronização do processo de trabalho da prática da dispensação farmacêutica. Foi detectado que a qualidade dos instrumentos utilizados para avaliar o processo de trabalho da dispensação não foi, muitas vezes, avaliada. Nove indicadores de qualidade no processo de trabalho da dispensação prática foram encontrados. – Na segunda revisão sistemática foram incluídos 65 artigos, sendo que a maior parte dos estudos utilizou o método do Paciente Simulado, com a maioria dos pacientes apresentando comportamento passivo. Foram listadas e quantificadas as perguntas e orientações mais comuns realizadas pelos farmacêuticos como: identificação e condição clínica do paciente, indicação, dose e ação do medicamento, alergia, duração do tratamento, efeitos adversos, interações medicamentosas, tratamentos não farmacológicos e encaminhamento ao médico. – Na terceira revisão sistemática foram incluídos 26 artigos. Poucos estudos abordaram a documentação como parte do processo de trabalho da dispensação e a maioria documentou por meio de instrumentos não informatizados. Conclusão: Estudos e a prática da dispensação farmacêutica devem ser padronizados, o que irá facilitar a comparação dos resultados e medir o processo de trabalho desse serviço. Protocolos, algoritmos e documentação da prática são necessários para guiar, padronizar o processo de trabalho da dispensação e medir o impacto das intervenções dos farmacêuticos comunitários no cuidado ao paciente.

Doctor Pharmaceuticae - DPharm / The effect of industrialisation has thrust the pharmaceutical profession into a clinical paradigm where the approcah to pharmaceutical decisions is more disease and patient orientated. Consequently, South African community pharmacies are inundated with requests from the public for advice and treatment on a wide range of medical conditions, including sexually transmitted infections (STI's). Although community pharmacies are often the first port of call for undiagnosed STI, limited diagnostic skills and legally-imposed prescribing restrictions preclude pharmacists from providing the necessary clinical management. The overarching goal of this dissertation was to present objective arguments and evidences (new and existing) around an expanded role for pharmacists in STI partner management. / South Africa

Long-term conditions (LTCs) such as diabetes, cardiovascular diseases, respiratory diseases and cancers are recognised as the greatest challenge facing public healthcare systems globally in the 21st century. Healthcare provision for people with LTCs is shifting towards a model that puts patients at the centre of their own care through supported self-care. Self-care support has emerged as a distinct concept in the management of LTCs and is now considered an inseparable component of high quality healthcare provided by healthcare professionals. People with LTCs are regular users of community pharmacy where dispensing and other services provide opportunities for self-care support. While self-care support as a concept has been explored extensively in health disciplines like nursing, medicine and health psychology, there is a paucity of published literature in community pharmacy. The main aim of this programme of work was to explore the place and contribution of community pharmacy in self-care support of LTCs. A preliminary scoping literature review captured and synthesised the overarching components of self-care support of LTCs into a single theoretical framework consisting of collaborative care planning, self-care information and advice, self-care skills support and training, self-care support networks and self-care technology. The research programme of work employed a mixed methods design consisting of three Work Streams. The qualitative arm of the programme consisted of semi-structured interviews with 24 patients with LTCs and 24 community pharmacists in England and Scotland; these informed the quantitative arm, which was a cross-sectional, online survey of 10,000 community pharmacists in England. The survey instrument was informed and developed from the findings of the pharmacists’ interviews in combination with existing literature. Data collection and analysis in the three work streams incorporated the theoretical framework of self-care support. The qualitative data analyses were undertaken thematically, while quantitative data were analysed using a range of descriptive and inferential statistics. Interviews with patients explored their ‘lived experience’ with LTCs and found that self-care was an integral part of daily living; patients engaged in self-care in a variety of ways to attain normality in their lives. Patients used a wide range of resources for self-care support; family/carers, friends and healthcare professionals (mainly doctors and nurses). Patients viewed and used community pharmacy mainly for the supply of prescribed medicines and suggested that community pharmacy played minimal roles in self-care support. The interviews and survey of community pharmacists showed that pharmacists recognised the broad range of activities and principles of self-care. However, in terms of pharmacists’ contributions to self-care support, their perspectives were narrower and focussed on providing information and advice on medicines-use to patients, while other activities such as lifestyle advice were provided opportunistically. They indicated that they were already providing medicines-focussed self-care support through the services available in community pharmacy. The theoretical framework allowed detailed exploration of how community pharmacists operationalised the different elements of self-care support of LTCs. Collaborative care planning was viewed as important but not within the remit of community pharmacy. Self-care information and advice was unidimensional and provided opportunistically and one-off, using the paternalistic biomedical model. Pharmacists valued the roles of patients’ personal communities but were not proactive in signposting to other support networks. Self-care skills training and support and the use of self-care technologies were limited. Barriers to providing self-care support were priority accorded to dispensing activities, the structure of the community pharmacy contract, lack of incentives to provide self-care support and patients’ expectations and lack of awareness of community pharmacy’s role in LTCs management. The theoretical framework of self-care support of LTCs provided novel insights into the perspectives of patients and community pharmacists. The findings highlighted the need for a coherent LTC strategy if community pharmacy is to align with the self-care support paradigm. Recommendations are made for a comprehensive package of care, underpinned by self-care support. A case is also made for incorporating the often ‘unheard’ patient voice into community pharmacy research and interventions.