Improving access to community pharmacy services for disabled people in Aotearoa New Zealand

Abstract

Background: Community pharmacy and the services delivered in this setting are essential to the primary healthcare system of Aotearoa New Zealand. Disabled people are a social group widely recognised to experience poor access to health services. Health professionals may be unprepared to meet the diverse needs of disabled people. Despite this, limited research has been conducted exploring the accessibility of community pharmacy services to disabled people. This thesis will report on a PhD project that used a co-design approach to explore access issues for disabled people and identify potential actions to improve access to community pharmacy services in Aotearoa New Zealand. Methods: A participatory action research methodology was adopted; in which the findings from a systematic literature review, a survey of community pharmacists (n=277), a series of focus groups with disabled people (n=64), and interviews with community pharmacists (n=13) helped to identify the access issues and action areas to improve access to community pharmacy services for disabled people. Results: Disabled people reported various practical access issues such as communication barriers, lack of access to information, limited understanding of medicines subsidy and poor physical access in the community pharmacy setting. It was found that familiarity between disabled people and their pharmacists may help to mitigate these issues. However, a core socio-political challenge identified by disabled people is their lack of inclusion in community pharmacy services design and development. This context contributes to the lack of responsiveness of community pharmacy services to the diverse needs of disabled people. Community pharmacists reported that many community pharmacies settings could be improved to accommodate the needs of their disabled service users. They also confirmed some of the practical issues that disabled people raised. Many believed they lacked the skills and capacity required to meet the needs of some disabled people adequately. Representatives advocated that the skillset pharmacists have could greatly benefit the health of disabled people. However, the community pharmacy context is not adequately resourced and supported to enable access to pharmacists' expertise for many disabled people. Conclusions: The findings of this project suggest that the accessibility of community pharmacy can be significantly improved for disabled people, which will, in turn, advance their health and wellbeing. Gains could also be made for service development by creating a robust co-design platform that values the expertise of disabled people and pharmacists.