Pharmacists’ perspectives on medication therapy management training needs for chronic disease care in Indonesian primary healthcare centers: a qualitative study across 32 provinces

BACKGROUND: Chronic diseases place a growing burden on health systems and require effective strategies to support long-term medication use. Medication Therapy Management (MTM) has been shown to improve clinical outcomes in chronic disease care, but its implementation depends on pharmacists' competencies and access to structured training. In Indonesia, MTM remains inconsistently implemented in primary healthcare centers (PHCs), and pharmacists have reported competency gaps in the absence of standardized training. Evidence to inform context-specific training design is limited. The objective of this study was to explore and identify Indonesian PHC pharmacists' perspectives on training for chronic-disease MTM, including their needs, preferences, perceived challenges, and facilitators. METHODS: This paper reports the qualitative component of a larger mixed-methods study. A qualitative descriptive study was conducted using six focus group discussions (FGDs) with 32 PHC pharmacists from 32 provinces in Indonesia. Participants were purposively selected based on their experience in PHCs (≥ 6 months). All audio recordings were transcribed verbatim and then analyzed using an inductive thematic approach in Atlas.ti. To strengthen the credibility of the findings, we used triangulation, member checking, and peer debriefing during the analysis. RESULTS: The analysis generated four themes: needs, preferences, challenges, and facilitators. Pharmacists emphasized a need for standardized, competency-based, and practice-oriented MTM training. They strongly preferred content that aligned with daily practice and focused on prevalent chronic diseases. However, they also identified several contextual challenges that might influence implementation, including geographical and cost barriers, limited digital access, and competing responsibilities. Institutional and policy support, as well as post-training mechanisms, were considered factors that may facilitate learning sustainability and implementation in routine care. CONCLUSIONS: Pharmacists in Indonesian PHCs perceive clear needs, preferences, challenges, and facilitators for MTM training. These findings can inform the development of context-sensitive, competency-based training programs. Embedding such training into continuing professional development frameworks is recommended to strengthen its sustainability and long-term impact, contributing to health professions education for primary care pharmacists.