Thematic analysis of community pharmacy views of the digital prescribing and dispensing pathway in Scotland

Abstract Introduction The Digital Prescribing and Dispensing Pathway (DPDP) is a multiparty programme commissioned by Scottish Government, delivered by both National Services Scotland (NSS) and NHS Education for Scotland (NES).[1] The DPDP team is multifaceted and includes technical and programme management teams and subject matter experts. The DPDP programme aims to transform the in-hours GP practice prescribing to community pharmacy dispensing pathway by creating an end-to-end digital solution. DPDP will be a cloud-based system where community pharmacies will download items to dispense into their patient medication records (PMR) system and provide the flexibility of single item dispensing. Implementation of DPDP and removal of the paper prescription will be a seismic change for community pharmacies and will be the most substantial operational shift over the past two decades. Aim This study aimed to explore the opinions of community pharmacists on the implementation of a digital prescribing and dispensing pathway in Scotland and identify the complexities of the changes to the current dispensing model. Methods This study applied a qualitative approach of semi-structured face-to-face interviews and the objective was to interview 5% of community pharmacists across the three largest health boards in Scotland (Glasgow, Lothian and Lanarkshire). Thirty-three community pharmacies were identified for participation and purposive sampling was used to ensure equity of representation across independent contractors and the Community Chemists Association; the five PMR suppliers active in Scotland; a broad scope of items dispensed; and a variety of socioeconomic landscapes. Interviews were transcribed verbatim via an artificial intelligence (AI) tool, WhisperTranscribe, and NVivo was used to support inductive thematic analysis of the data. Results Of the thirty-three community pharmacists invited, thirty-one agreed to participate; twenty-nine interviews were completed and after one participant declined AI use, twenty-eight were analysed. Fifty seven percent of participants were female, and the number of years qualified ranged from 2–39 years. Data analysis derived five themes (benefits, people, logistics, marketplace evolution and technology) and associated sub-themes. Participants suggested there were high confidence levels for using DPDP technology but inconsistent confidence levels for the implementation of DPDP in Scotland. Key concerns predominantly related to anxieties around the back up and support systems, the process for financial remuneration of dispensed items, methods of delivering training and the threat of the online pharmacy business to independent contractors. Conclusion This study has strength in the methodical approach used to analyse data and identify participants but focused solely on community pharmacists’ views and could be viewed as having Central Belt bias. Community pharmacy stakeholders have mixed perceptions of the prospects of DPDP in Scotland and have identified concerns surrounding the impact on the current dispensary model. Whilst this study suggests that community pharmacists are ready to embrace DPDP, there is concern surrounding potential disruption to the service provided to patients and how this will be managed. There is a need for continued engagement with community pharmacists and wider community pharmacy teams to ensure the DPDP product build and resultant minimum viable product (MVP) are fit for purpose in creating a robust digital dispensary.