Gellatly Stephanie, Moszczynski Alexander, Fiedeldey Lean, Houle Sherilynn, Smith Maxwell, Ogbogu Ubaka, Rudman Debbie, Minaker Leia, Shelley Jacob
Faculty of Law, University of Western Ontario, 1151 Richmond Street, London, ON N6A 3K7, Canada.
Faculty of Health Sciences, University of Western Ontario, 1151 Richmond Street, London, ON N6A5B9, Canada.
Explor Res Clin Soc Pharm. 2023 Jul 18;11:100312. doi: 10.1016/j.rcsop.2023.100312. eCollection 2023 Sep.
Community pharmacists are expected to uphold ethical duties to patients and society while maintaining independent businesses or fulfilling expectations of corporate owners. Canadian pharmacy colleges provide only indirect guidance on the retail setting of the profession. Little is known about whether pharmacists identify ethical issues in retail pharmacy or around the sales of non-drug products.
This study sought to examine pharmacists' perceptions of their roles in health promotion, the factors that influence the selection of front-of-store products, and ethical issues relating to their dual roles as health care providers and retailers.
In 2020, 25 Canadian pharmacists participated in semi-structured phone interviews. Interviews were audio-recorded, anonymized, transcribed verbatim, and thematically analyzed using qualitative methods.
Almost all participants described their role primarily as a health care provider, though some described themselves as 50-50 health care providers and retailers. Most staff pharmacists reported little control over front-of-store product selection. Where participants reported some control, external factors such as business viability and profitability impacted their choices, though some reported selecting products based on the needs of their patient community or their personal beliefs. The dominant tensions described stemmed from participants' dual roles as health care providers and retailers, though specific issues and situations were varied, ranging corporate targets, to service provision, to the sales of unproven or unhealthy products. Participants suggested solutions to the issues they described, ranging from a complete overhaul of the licensing structure of community pharmacies, down to one-on-one conversations with patients.
Our findings suggest that the retail setting of community pharmacy produces unique ethical tensions: the imposition of retail sales standards and targets are commonplace, and business viability is a primary driving force in front-of-store product selection. Clear guidance from Canadian pharmacy colleges and legislators to address these tensions and issues may be necessary.
社区药剂师在维持独立业务或满足企业所有者期望的同时，需要履行对患者和社会的道德责任。加拿大药学院仅对该行业的零售环境提供间接指导。对于药剂师是否识别零售药房或非药品销售中的道德问题，我们知之甚少。
本研究旨在探讨药剂师对其在健康促进中角色的认知、影响店前产品选择的因素，以及与他们作为医疗服务提供者和零售商的双重角色相关的道德问题。
2020年，25名加拿大药剂师参与了半结构化电话访谈。访谈进行了录音、匿名处理、逐字转录，并采用定性方法进行主题分析。
几乎所有参与者都将自己的角色主要描述为医疗服务提供者，尽管有些人将自己描述为医疗服务提供者和零售商各占一半。大多数药剂师表示对店前产品选择几乎没有控制权。在参与者表示有一定控制权的情况下，诸如商业可行性和盈利能力等外部因素会影响他们的选择，不过也有人表示是根据患者群体的需求或个人信念来选择产品。所描述的主要矛盾源于参与者作为医疗服务提供者和零售商的双重角色，尽管具体问题和情况各不相同，从企业目标到服务提供，再到未经证实或不健康产品的销售。参与者针对他们所描述的问题提出了解决方案，从彻底改革社区药房的许可结构，到与患者进行一对一的交谈。
我们的研究结果表明，社区药房的零售环境产生了独特的道德矛盾：零售销售标准和目标的强制实施很常见，商业可行性是店前产品选择的主要驱动力。加拿大药学院和立法者可能需要提供明确的指导，以解决这些矛盾和问题。
