Women's perspectives on acute cystitis care and the role of the community pharmacy: a qualitative study

Background Acute cystitis (AC) is a common reason for women to visit their general practitioner (GP). To reduce GP workload and improve accessibility, some countries allow community pharmacist who do not typically independently prescribe, to diagnose and treat women with AC. Objective To explore women's experiences with current AC care and their perspectives on the community pharmacy's role including the potential use of a validated questionnaire to diagnose AC, the ‘Acute Cystitis Symptom Score (ACSS)’. Methods Semi-structured interviews were conducted with women with a history of AC. Participants with variation in age and ethnic background were recruited through one community pharmacy in the Netherlands. Interview topics were experiences with current AC care, perspectives on a questionnaire-based diagnosis, perspectives on task shifting to the pharmacy and knowledge of self-care and lifestyle advices. The interviews were audio-recorded, transcribed and thematically analyzed. Results In total, 35 women (median age: 57 years) were included. They were generally satisfied with the current AC care by the GP, but reported concerns about accessibility. Women mentioned both risks (e.g., doubts about pharmacy capabilities) and benefits (e.g., improved accessibility) of a service through the community pharmacy. Most prerequisites for such a service were related to clear GP-pharmacist collaboration. Women were concerned about potential false-positive or false-negative outcomes of the ACSS. Conclusions Women were generally satisfied with current AC care. They saw both risks and benefits with expanding the community pharmacy's role in AC care and using the ACSS. For this to be implementable, pharmacists need adequate skills, resources, and strong collaboration with GPs.