Barriers for the implementation of cognitive services in Spanish community pharmacies

Objective. To identify and assess barriers for dissemination, implementation, and sustainability of different cognitive services in Spanish community pharmacies. Design. Qualitative study through semistructured interviews followed by a descriptive analysis. Method. Two groups of experts related to Spanish community pharmacy were chosen. One with 15 community pharmacists with a relevant professional activity, while the other group (n=18) was related to pharmacy strategists. Results. The lack of university clinical oriented learning, lack of pharmacists' attitude towards change and some uncertainty over their professional future were identified as barriers at the pharmacists' level. In relation to pharmacy as an organization the lack of clear messages by their leaders and the small volume of Spanish pharmacies were identified as barriers. In the category of pharmacy profession, the current reimbursement system, the lack of university clinical education, and the lack of leadership by current representative organizations were the barriers found. The lack of real involvement by health authorities, the lack of knowledge about the objectives of pharmacy cognitive services, and the lack of demand of these services by patients where also identified as barriers. Conclusions. Finally, 12 barriers were identified and grouped into 6 categories. These barriers fit in with the barriers identified in other countries