SpringerLink
Log in

Barriers to person-centered service design in pharmacy practice: examples, lessons, and potential solutions

  • Commentary
  • Published:
International Journal of Clinical Pharmacy Aims and scope Submit manuscript

Abstract

Despite increased attention to, and frameworks conceptualizing person-centered care, systematic, organizational, and provider-level barriers continue to discourage the development and delivery of person-centered care (PCC) in pharmacy practice and beyond. This commentary describes existing pharmacy-specific literature related to PCC, barriers to PCC within the context of pharmacy practice, and potential solutions to increase person-centeredness in pharmacy services. Literature to substantiate and describe barriers and potential solutions was identified from 2008 to 2023, a period where the emphasis on PCC in pharmacy practice dramatically increased. Overall, pharmacy-specific literature was identified describing four key barriers to PCC. Several potential solutions were identified, including: using innovative and theory-informed approaches to collecting individual need and preference information, employing processes and equip** providers to facilitate trust, changing organizational culture, and aligning quality metrics and financial incentives with PCC. Identified solutions may be used to address individual, organizational, and systematic barriers to promote PCC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Germany)

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Vasilevskis EE, Shah AS, Hollingsworth EK, et al. A patient-centered deprescribing intervention for hospitalized older patients with polypharmacy: rationale and design of the Shed-MEDS randomized controlled trial. BMC Health Serv Res. 2019;19:165.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Wolf MS, Davis TC, Curtis LM, et al. A patient-centered prescription drug label to promote appropriate medication use and adherence. J Gen Intern Med. 2016;31:1482–9.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Wolters M, van Hulten R, Blom L, et al. Exploring the concept of patient centred communication for the pharmacy practice. Int J Clin Pharm. 2017;39:1145–56.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Sinaiko AD, Szumigalski K, Eastman D, et al. Delivery of Patient Centered Care in the US Health Care System: What is standing it its Way? 2019. https://academyhealth.org/sites/default/files/deliverypatientcenteredcare_august2019.pdf. Accessed 24 Oct 2023.

  5. Olson AW, Burns AL. From patient centered to person centered: the pharmacist’s role and value in community-integrated care transformation. J Am Pharm Assoc. 2023;63:736–41.

    Article  Google Scholar 

  6. Barnett N. Person-centred over patient-centred care: not just semantics. Clin Pharm. 2018. 10(4). https://doi.org/10.1211/PJ.2018.20204578

  7. Person-Centered Care. Centers for Medicare and Medicaid Services. Available from: https://www.cms.gov/priorities/innovation/key-concepts/person-centered-care. Accessed 8 Dec 2023.

  8. Grover S, Fitzpatrick A, Azim FT, et al. Defining and implementing patient-centered care: an umbrella review. Patient Educ Couns. 2022;105:1679–88.

    Article  PubMed  Google Scholar 

  9. Peat G, Fylan B, Breen L, et al. Person-centred deprescribing for patients living with frailty: a qualitative interview study and proposal of a collaborative model. Int J Pharm Pract. 2023;31:282–9.

    Article  PubMed  Google Scholar 

  10. Giusti A, Pukrittayakamee P, Alarja G, et al. Develo** a global practice-based framework of person-centred care from primary data: a cross-national qualitative study with patients, caregivers and healthcare professionals. BMJ Glob Health. 2022;7:e008843.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Santana MJ, Manalili K, Jolley RJ, et al. How to practice person-centred care: A conceptual framework. Health Expect. 2018;21:429–40.

    Article  PubMed  Google Scholar 

  12. Barnett NL. Guide to undertaking person-centred inpatient (ward) outpatient (clinic) and dispensary-based pharmacy consultations. Eur J Hosp Pharm. 2020;27:302–5.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Greene SM, Tuzzio L, Cherkin D. A framework for making patient-centered care front and center. Perm J. 2012;16:49–53.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Sepp K, Cavaco A, Volmer D. The principles of person-centredness in quality patient care-Evaluation of the Community Pharmacy Services Quality Guidelines in Estonia. Int J Health Plann Manage. 2022;37:101–14.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Gyllensten H, Fuller JM, Östbring MJ. Commentary: how person-centred is pharmaceutical care? Int J Clin Pharm. 2022;44:270–5.

    Article  PubMed  Google Scholar 

  16. Krist AH, Davidson KW, Ngo-Metzger Q. What evidence do we need before recommending routine screening for social determinants of health? Am Fam Physician. 2019;99:602–5.

    PubMed  Google Scholar 

  17. Cantor MN, Thorpe L. Integrating data on social determinants of health into electronic health records. Health Aff. 2018;37:585–90.

    Article  Google Scholar 

  18. Vahdat S, Hamzehgardeshi L, Hessam S, et al. Patient involvement in health care decision making: a review. Iran Red Crescent Med J. 2014;16:e12454–e12454.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Murry LT, Viyurri B, Chapman CG, et al. Patient preferences and willingness-to-pay for community pharmacy-led Medicare Part D consultation services: a discrete choice experiment. Res Social Adm Pharm. 2023;19:764–72.

    Article  PubMed  Google Scholar 

  20. Kibicho J, Owczarzak J. A patient-centered pharmacy services model of HIV patient care in community pharmacy settings: a theoretical and empirical framework. AIDS Patient Care STDS. 2012;26:20–8.

    Article  PubMed  Google Scholar 

  21. Fischer M, Safaeinili N, Haverfield MC, et al. Approach to Human-Centered, Evidence-Driven Adaptive Design (AHEAD) for health care interventions: a proposed framework. J Gen Intern Med. 2021;36:1041–8.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Bartlett R, Boyle JA, Smith JS, et al. Evaluating human-centred design for public health: a case study on develo** a healthcare app with refugee communities. Res Involv Engagem. 2021;7:32.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Melles M, Albayrak A, Goossens R. Innovating health care: key characteristics of human-centered design. Int J Qual Health Care. 2021;33:37–44.

    Article  PubMed  Google Scholar 

  24. Flood M, Ennis M, Ludlow A, et al. Research methods from human-centered design: potential applications in pharmacy and health services research. Res Social Adm Pharm. 2021;17:2036–43.

    Article  PubMed  Google Scholar 

  25. Murry LT, Al-Khatib A, Witry MJ. Using journey map** to understand the patient experience with selecting a Medicare part D plan using a pharmacy consultation service. Explor Res Clin Soc Pharm. 2021;1:100006.

    PubMed  PubMed Central  Google Scholar 

  26. Murry LT, Desselle SP. Beyond satisfaction in person-centered pharmacy services. Explor Res Clin Soc Pharm. 2023;12:100355.

    PubMed  PubMed Central  Google Scholar 

  27. Dopp AR, Parisi KE, Munson SA, et al. Aligning implementation and user-centered design strategies to enhance the impact of health services: results from a concept map** study. Implement Sci Commun. 2020;1:17.

    Article  PubMed  PubMed Central  Google Scholar 

  28. O’Hara KL, Knowles LM, Guastaferro K, et al. Human-centered design methods to achieve preparation phase goals in the multiphase optimization strategy framework. Implement Res Pract. 2022;3:26334895221131052.

    PubMed  PubMed Central  Google Scholar 

  29. Moore JE, Mascarenhas A, Bain J, et al. Develo** a comprehensive definition of sustainability. Implement Sci. 2017;12:1–8.

    Article  Google Scholar 

  30. Damschroder LJ, Reardon CM, Widerquist MAO, et al. The updated consolidated framework for implementation research based on user feedback. Implement Sci. 2022;17:75.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Damschroder LJ, Aron DC, Kieth RE. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4:1–15.

    Article  Google Scholar 

  32. Holden RJ, Hill JR, Campbell NL, et al. Human-centered design and research in deprescribing. Proc Hum Factors Ergonom Soc Annu Meet. 2021;65:398–402.

    Article  Google Scholar 

  33. Ie K, Machino R, Albert SM, et al. Deprescribing as an opportunity to facilitate patient-centered care: a qualitative study of general practitioners and pharmacists in Japan. Int J Environ Res Public Health. 2023;20:3543.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Silcock J, Marques I, Olaniyan J, et al. Co-designing an intervention to improve the process of deprescribing for older people living with frailty in the United Kingdom. Health Expect. 2023;26:399–408.

    Article  PubMed  Google Scholar 

  35. Ailabouni NJ, Reeve E, Helfrich CD, et al. Leveraging implementation science to increase the translation of deprescribing evidence into practice. Res Social Adm Pharm. 2022;18:2550–5.

    Article  PubMed  Google Scholar 

  36. Breckenridge LA, Burns D, Nye C. The use of motivational interviewing to overcome COVID-19 vaccine hesitancy in primary care settings. Public Health Nurs. 2022;39:618–23.

    Article  PubMed  Google Scholar 

  37. Håkansson Eklund J, Holmström IK, Kumlin T, et al. “Same same or different?” A review of reviews of person-centered and patient-centered care. Patient Educ Couns. 2019;102:3–11.

    Article  PubMed  Google Scholar 

  38. Trachtenberg F, Dugan E, Hall MA. How patients’ trust relates to their involvement in medical care. J Fam Pract. 2005;54:344–52.

    PubMed  Google Scholar 

  39. Mikesell L, Bontempo AC. Healthcare providers’ impact on the care experiences of patients with endometriosis: the value of trust. Health Commun. 2023;38:1981–93.

    Article  PubMed  Google Scholar 

  40. Viskupič F, Wiltse DL, Meyer BA. Trust in physicians and trust in government predict COVID-19 vaccine uptake. Soc Sci Q. 2022;103:509–20.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Nguyen TC, Gathecha E, Kauffman R, et al. Healthcare distrust among hospitalised black patients during the COVID-19 pandemic. Postgrad Med J. 2022;98:539–43.

    Article  PubMed  Google Scholar 

  42. Wilson Y. Is trust enough? anti-black racism and the perception of black vaccine “hesitancy.” Hastings Cent Rep. 2022;52:S12–7.

    Article  PubMed  Google Scholar 

  43. Worley MM, Schommer JC, Brown LM, et al. Pharmacists’ and patients’ roles in the pharmacist-patient relationship: are pharmacists and patients reading from the same relationship script? Res Social Adm Pharm. 2007;3:47–69.

    Article  PubMed  Google Scholar 

  44. Worley MM. Testing a pharmacist-patient relationship quality model among older persons with diabetes. Res Social Adm Pharm. 2006;2:1–21.

    Article  PubMed  Google Scholar 

  45. Gregory PA, Austin Z. How do patients develop trust in community pharmacists? Res Social Adm Pharm. 2021;17:911–20.

    Article  PubMed  Google Scholar 

  46. Gregory PA, Austin Z. Understanding the psychology of trust between patients and their community pharmacists. Can Pharm J. 2021;154:120–8.

    Article  Google Scholar 

  47. Green J. Is trust an under-researched component of healthcare organisation? BMJ. 2004;329:384.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Lee YY, Lin JL. Linking patients’ trust in physicians to health outcomes. Br J Hosp Med. 2008;69:42–6.

    Article  Google Scholar 

  49. Rolfe A, Cash-Gibson L, Car J, et al. Interventions for improving patients’ trust in doctors and groups of doctors. Cochrane Database Syst Rev. 2014;3:CD004134.

    Google Scholar 

  50. Liu J, He J, He S, et al. Patients’ self-disclosure positively influences the establishment of patients’ trust in physicians: an empirical study of computer-mediated communication in an online health community. Front Public Health. 2022;10:823692.

    Article  PubMed  PubMed Central  Google Scholar 

  51. King C, Collins D, Patten A, et al. Trust in hospital physicians among patients with substance use disorder referred to an addiction consult service: a mixed-methods study. J Addict Med. 2022;16:41–8.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Dehlendorf C, Fitzpatrick J, Steinaur J, et al. Development and field testing of a decision support tool to facilitate shared decision making in contraceptive counseling. Patient Educ Couns. 2017;100:1374–81.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Imeri H, Desselle S, Hetemi D, et al. Mobile electronic devices as means of facilitating patient activation and health professional empowerment related to information seeking on chronic conditions and medications: qualitative study. JMIR Mhealth Uhealth. 2021;9:e26300.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Badowski ME, Bente JA, Davis EM, et al. Telehealth and technological applications in patient-centered care: implications for pharmacy learners and clinical pharmacists. J Am Coll Clin Pharm. 2021;4:1044–55.

    Article  Google Scholar 

  55. Khoshnam-Rad N, Gholamzadeh M, Gharabaghi MA, et al. Rapid implementation of telepharmacy service to improve patient-centric care and multidisciplinary collaboration across hospitals in a COVID era: a cross-sectional qualitative study. Health Sci Rep. 2022;5:e851.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Mohiuddin SI, Thorakkattil SA, Abushoumi F, et al. Implementation of pharmacist-led tele medication management clinic in ambulatory care settings: a patient-centered care model in COVID-19 Era. Explor Res Clin Soc Pharm. 2021;4:100083.

    PubMed  PubMed Central  Google Scholar 

  57. van Velsen L, Tabak M, Hermens H. Measuring patient trust in telemedicine services: development of a survey instrument and its validation for an anticoagulation web-service. Int J Med Inform. 2017;97:52–8.

    Article  PubMed  Google Scholar 

  58. Batalden P. Getting more health from healthcare: quality improvement must acknowledge patient coproduction—an essay by Paul Batalden. BMJ. 2018;362:k3617.

    Article  PubMed Central  Google Scholar 

  59. Sawan M, Jeon YH, Fois RA, et al. Exploring the link between organizational climate and the use of psychotropic medicines in nursing homes: A qualitative study. Res Social Adm Pharm. 2017;13:513–23.

    Article  PubMed  Google Scholar 

  60. Adams AJ, Desselle SP, McKeirnan KC. Pharmacy technician-administered vaccines: on perceptions and practice reality. Pharmacy. 2018;6:124.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Wasem V, Woodyard A, Desselle SP, et al. Correlations to and potential implications of resilience among certified pharmacy technicians. J Am Pharm Assoc. 2023;63:90–6.

    Article  Google Scholar 

  62. Jenssen BP, Buttenheim AM, Fiks AG. Using behavioral economics to encourage parent behavior change: opportunities to improve clinical effectiveness. Acad Pediatr. 2019;19:4–10.

    Article  PubMed  Google Scholar 

  63. Elrod JK, Fortenberry JL. Centers of excellence in healthcare institutions: What they are and how to assemble them. BMC Health Serv Res. 2017;17:425.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Bokhour BG, Fix GM, Mueller NM, et al. How can healthcare organizations implement patient-centered care? Examining a large-scale cultural transformation. BMC Health Serv Res. 2018;18:168.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Alimoglu MK, Alparslan D, Daloglu M, et al. Does clinical training period support patient-centeredness perceptions of medical students? Med Educ Online. 2019;24:1603525.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Fong S, Tan A, Czupryn J, et al. Patient-centred education: How do learners’ perceptions change as they experience clinical training? Adv Health Sci Educ Theory Pract. 2019;24:15–32.

    Article  PubMed  Google Scholar 

  67. Ahn J, Kim M. Influencing factors on person-centered care competence among nursing students experienced clinical training. Medicina. 2021;57:1295.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Gantayet-Mathur A, Chan K, Kalluri M. Patient-centered care and interprofessional collaboration in medical resident education: Where we stand and where we need to go. Humanit Soc Sci Commun. 2022;9:206.

    Article  Google Scholar 

  69. Sidani S, van Soeren M, Jurlock-Chorostecki C, et al. Health professionals’ and patients’ perceptions of patient-centered care: a comparison. Eur J Pers Cent Healthc. 2016;4:641–9.

    Google Scholar 

  70. Urick BY, Pathak S, Hughes TD, et al. Design and effect of performance-based pharmacy payment models. J Manag Care Spec Pharm. 2021;27:306–15.

    PubMed  Google Scholar 

  71. Kim J, Combs K, Downs J, et al. Medication adherence: the elephant in the room. US Pharm. 2018;43:30–4.

    Google Scholar 

  72. García-Sempere A, Hurtado I, Senfelix-Genoves J, et al. Improving the accuracy of medication adherence measures using linked prescription and dispensation data: findings from the ESOSVAL cohort of patients treated with osteoporosis drugs. Curr Med Res Opin. 2019;35:1535–44.

    Article  PubMed  Google Scholar 

  73. Canfield SL, Zuckerman A, Anguiano RH, et al. Navigating the wild west of medication adherence reporting in specialty pharmacy. J Manag Care Spec Pharm. 2019;25:1073–7.

    PubMed  Google Scholar 

  74. George DL, Smith MJ, Draugalis JR, et al. The use of think-aloud protocols to identify a decision-making process of community pharmacists aimed at improving CMS Star Ratings scores. Res Social Adm Pharm. 2018;14:262–8.

    Article  PubMed  Google Scholar 

  75. Steve Tsang CC, Wan JY, Chisholm-Burns MA, et al. Racial/ethnic disparities in measure calculations for Part D Star Ratings among Medicare beneficiaries with diabetes, hypertension, and/or hyperlipidemia. Res Social Adm Pharm. 2021;17:1469–77.

    Article  PubMed  Google Scholar 

  76. Harrington A, Malone D, Doucette W, et al. A conceptual framework for evaluation of community pharmacy pay-for-performance programs. J Am Pharm Assoc. 2021;61:804–12.

    Article  Google Scholar 

  77. Spears J, Erkens J, Misquitta C, et al. A pharmacist-led, patient-centered program incorporating motivational interviewing for behavior change to improve adherence rates and star ratings in a medicare plan. J Manag Care Spec Pharm. 2020;26:35–41.

    PubMed  Google Scholar 

  78. Bacci JL, Hansen R, Ree C, et al. The effects of vaccination forecasts and value-based payment on adult immunizations by community pharmacists. Vaccine. 2019;37:152–9.

    Article  PubMed  Google Scholar 

Download references

Funding

No specific funding was received.

Author information

Authors and Affiliations

  1. The University of Iowa College of Pharmacy, 180 S Grand Ave, Iowa City, IA, 52242, USA

    Logan T. Murry

  2. The Accreditation Council for Pharmacy Education, Chicago, IL, 60603, USA

    Logan T. Murry

  3. Touro University College of Pharmacy, Vallejo, CA, 94594, USA

    Shane P. Desselle

Authors
  1. Logan T. Murry
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shane P. Desselle
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Logan T. Murry.

Ethics declarations

Conflicts of interest

The authors have no conflicts of interest to declare.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Murry, L.T., Desselle, S.P. Barriers to person-centered service design in pharmacy practice: examples, lessons, and potential solutions. Int J Clin Pharm 46, 542–547 (2024). https://doi.org/10.1007/s11096-023-01689-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-023-01689-4

Keywords

Search

Navigation