Pharmacist and physician perspectives on diabetes service delivery within community pharmacies in Indonesia: A qualitative study

Objective: To explore perspectives of physicians and pharmacists on diabetes service delivery within community pharmacies in Indonesia. Methods: In depth interviews were conducted with 10 physicians and 10 community pharmacists in Surabaya, Indonesia, using a semi-structured interview guide. Nvivo version 9 was used to facilitate thematic content analysis to identify barriers/facilitators for community pharmacists to provide diabetes services. Key findings: The identified themes indicating barriers/facilitators for diabetes service delivery within Indonesian community pharmacies included: (1) pharmacist factors-i.e. positive views (facilitator) and perceived lack of competence (barrier); (2) pharmacist-physician relationships - i.e. physicians' lack of support and accessibility (barriers); (3) pharmacist-patient relationships - i.e. perceived patients' lack of support and accessibility (barriers); (4) pharmacy environment-i.e. business orientation (barrier), lack of staff and poor pharmacist availability (barriers), and availability of supporting resources, such as counselling areas/rooms, procedures/protocols and IT systems for labelling and patient records (facilitators); and (5) external environment-i.e. a health system to support pharmacist roles, remuneration, marketing and professional assistance (facilitators). Conclusion: Issues related to the pharmacist-physician-patient relationships, pharmacy environment and external environment need to be addressed before Indonesian community pharmacists can provide additional pharmacy services for type 2 diabetes patients. Collaboration between the Government, IkatanApotekerIndonesia (Indonesian Pharmacists Association) and IkatanDokterIndonesia (Indonesian Medical Association) is required to improve the pharmacy professional environment and facilities