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Patient-centred care: what consumer health organisations say and do

Fiona Sharne Kelly, Adem Sav, Sara McMillan, Michelle A. King, Jennifer A. Whitty, Amanda J. Wheeler


Concepts like patient-centered care and shared decision making are increasingly prominent topics in discourse on quality in healthcare with the growing prevalence of chronic disease. Although patient-centered care has been touted as a way forward, it remains an ambiguous concept with variable application in healthcare. Greater clarity is needed around the concept of patient-centered care alongside a stronger knowledge base on the perspectives of health consumers with complex needs and service providers, including those outside the formal healthcare system, such as consumer health organizations (CHO). This study explored CHO patient-centered policy, related practice, and organizational views on the potential value of pharmacy delivered patient-centered care.  In-depth interviews were conducted with 15 organizational representatives until no new themes emerged. Data were concurrently thematically analyzed by three researchers from a public health or pharmacy background.  Participants called for a paradigm shift away from the paternalistic biomedical model to shared power that values consumer choice and promotes active engagement in health. There was disparity between articulation of policy and practice, with CHOs often more patient-centered than they claimed to be.  Participants described a wealth of innovative and often patient-centered services, and ascribed under-utilization of these resources to limited awareness. Selected CHOs adopted strategies that health professionals can learn from, such as combining multiple elements of patient-centered care and seeking to build consumer capacity to self-manage. Health professional education, current infrastructure and remuneration were cited as barriers to more widespread delivery of patient-centered care. However, participants suggested creative solutions to address selected factors, some specific to pharmacy. Both pharmacy and CHOs are under-utilized healthcare resources and there is potential for synergy between these sectors to promote patient-centered care.  Pharmacy could benefit from insight into the CHO perspective of patient-centered care and also increase utilization of CHO services through direct referral. 


patient-centred care; chronic illness; community pharmacy; health care service; consumer health organizations; self-management

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Gulland, A. (2011).Welcome to the century of the patient. British Medical Journal 342, d2057.

Marshall, M. & Bibby, J. (2011).Supporting patients to make the best decisions. British Medical Journal 342, d2117.

May, C., Montori, V. & Mair, F. (2009).We need minimally disruptive medicine. British Medical Journal 339, 485-487.

Moynihan, R. (2011). Power to the people. British Medical Journal 342, d2002.

The Salzburg Statement on Shared Decision Making, in Salzburg Global Seminar: The Greatest Untapped Resource in Healthcare? (2011). Informing and Involving Patients in Decisions about Their Medical Care Salzburg Global Seminar, Session 477.

Elwyn, G., Tilburt, J. & Montori, V.M. (2013).The ethical imperative for shared decision-making. European Journal for Person Centered Healthcare 1 (1) 129-131.

Commonwealth of Australia. (2010). Australia to 2050: future challenges. Commonwealth of Australia: ACT, Australia.

Australian Institute of Health and Welfare. (2012). Risk factors contributing to chronic disease. Cat. no. PHE 157. AIHW: Canberra.

World Health Organization. Noncommunicable diseases country profiles 2011. (Accessed: 10 January 2013). Available from:

Lozano, R., Naghavi, M., Foreman, K. et al. (2012). Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380 (9859) 2095-2128.

Australian Bureau of Statistics. National Health Survey: Summary of Results, 2007-2008 (Reissue). (2010) [cited 2 May 2011]; Available from:

Sav, A.,Kendall, E., McMillan, S.S., Kelly, F., Whitty, J.A. King, M.A. & Wheeler, A.J. (2013). 'You say treatment, I say hard work': treatment burden among people with chronic illness and their carers in Australia.Health & Social Care in the Community 21 (6) 665-674.

Rodbard, H.W., Green, A.J., Fox, K.M., Grandy, S. & SHIELD Study Group. (2010). Impact of type 2 diabetes mellitus on prescription medication burden and out-of-pocket healthcare expenses. Diabetes Research and Clinical Practice 87 (3) 360-365.

Longo, C.J., Fitch, M., Deber, R.B & Williams, A.P. (2006). Financial and family burden associated with cancer treatment in Ontario, Canada. Supportive Care in Cancer 14 (11) 1077-1085.

Gallacher, K., Morrison, D., Jani, B., Macdonald, S., May, C.R., Montori, V.M., Erwin, P.J., Batty, G.D., Eton, D.T., Langhorne, P. & Mair, F.S. (2013). Uncovering Treatment Burden as a Key Concept for Stroke Care: A Systematic Review of Qualitative Research. PLoS Medicine. 10 (6) e1001473.

University of South Australia, Harrison Health Research, Tony Lawson Consulting, and Australia's Health PLC. Consumer Experiences, Needs and Expectations of Community Pharmacy. (2005). Available from:

Coppa, K. & Boyle, F.M. (2003). The role of self-help groups in chronic illness management: A qualitative study. Australian Journal of Primary Health 9 (3) 68-74.

Young, C.E., Mutch, A.J., Boyle, F.M. & Dean, J.H. (2010). Investigating referral pathways from primary care to consumer health organisations. Australian Journal of Primary Health 16 (3) 260-267.

Boyle, F.M., Mutch, A.J., Dean, J.H., Dick, M-L. & Del Mar, C.B. (2009). Consumer health organisations for people with diabetes and arthritis: who contacts them and why? Health & Social Care in the Community 17 (6) 628-635.

World Health Organization. (2007). People Centred Health Care: A Policy Framework. World Health Organization: Western Pacific Region.

Jordan, J.E. & Osborne, R.H. (2007). Chronic disease self-management education programs: challenges ahead. Medical Journal of Australia 186 (2) 84-87.

Mead, N. & Bower, P. (2000). Patient-centredness: a conceptual framework and review of the empirical literature. Social Science and Medicine 51 (7) 1087-1110.

Bauman, A.E., Fardy, H.J. & Harris, P.G. (2003). Getting it right: why bother with patient-centred care? Medical Journal of Australia 179 (5) 253-256.

Leplege, A., Gzil, F., Cammelli, M., Lefeve, C., Pachoud, B. & Ville, I. (2007). Person-centredness: Conceptual and historical perspectives. Disability and Rehabilitation 29 (20-21) 1555-1565.

McMillan, S.S., Kendall, E., Sav, A., King, M.A., Whitty, J.A., Kelly, F. & Wheeler, A.J. (2013). Patient-Centered Approaches to Health Care: A Systematic Review of Randomized Controlled Trials. Medical Care Research and Review 70 (6) 567-596.

Morgan, S. & Yoder, L.H. (2012). A concept analysis of person-centered care. Journal of Holistic Nursing 30 (1) 6-15.

Dancet, E.A.F., D'Hooghe, T.M., Sermeus, W., van Empel, I., Strohmer, H., Wyns, C., Santa-Cruz, D., Nardo, L.G., Kovatchki, D., Vanlangenakker, L., Garcia-Velasco, J., Mulugeta, B., Nelen, W.L. & Kremer, J.A. (2012). Patients from across Europe have similar views on patient-centred care: an international multilingual qualitative study in infertility care. Human Reproduction 27 (6) 1702-1711.

McCormack, B. & McCance, T.V. (2006). Development of a framework for person-centred nursing. Journal of Advanced Nursing 56 (5) 472-479.

McMillan, S.S., Wheeler, A.J., Sav, A., King, M.A., Whitty, J.A., Kendall, E. & Kelly, F. (2012). Community pharmacy in Australia: A health hub destination of the future. Research in Social and Administrative Pharmacy 9 (6) 863-875.

Sav, A., McMillan, S.S., Kelly, F., Kendall, E., Whitty, J.A., King, M.A., & Wheeler, A.J. (2013). Treatment burden among people with chronic illness: what are consumer health organizations saying? Chronic Illness 9 (3) 220.232.

Neuman, W.L. (2010). Social Resarch Methods: Qualitative and Quantitative Approaches. 7th edition. Boston: Pearson Education.

Buetow, S. (2007). Qualitative research, in Health Research Methods: A Tabular Presentation, p. 65-86. New York: Nova Science Publishers.

National Health Priority Action Council (NHPAC). National Chronic Disease Strategy. (2006). (Cited: 2011 April 28). Available from:$File/stratal3.pdf.

Biernacki, P. & Waldorf, D. (1981). Snowball Sampling: Problems and Techniques of Chain Referral Sampling. Sociological Methods & Research 10 (2) 141-163.

Smith, F. (2002). Populations, settings and samples, in Research Methods in Pharmacy Practice, pp. 117-122. London: Pharmaceutical Press.

Walker, J.L. (2012). Research column. The Use of Saturation in Qualitative Research. Canadian Journal of Cardiovascular Nursing 22 (2) 37-41.

Kitto, S.C., Chesters, J. & Grbich, C. (2008). Quality in qualitative research. Medical Journal of Australia 188 (4) 243- 246.

Pope, C. & Mays, N. (2006). Qualitative Research in Health Care. 3rd edn. Q.R.i.H. Care: Blackwell Publishing Ltd.

Australian Nursing and Midwifery Council.(2005). National Competency Standards for the Nurse Practitioner, pp. 1-5. Canberra: Australian Nursing and Midwifery Council.

Pharmacy Council of New Zealand.(2011). Competence Standards for the Pharmacy Profession, pp. 1-26. Wellington: Pharmacy Council of New Zealand.

Beach, M.C., Price, E.G., Gary, T.L., Robinson, K.A., Gozu, A., Palacio, A., Smarth, C., Jenkes, M.W., Feuerstein, C., Bass, E.B., Powe, N.R. & Cooper, L.A. (2005). Cultural Competence: A Systematic Review of Health Care Provider Educational Interventions. Medical Care 43 (4) 356-373.

Schembri, S. &Sandberg, J. (2011). The experiential meaning of service quality. Marketing Theory 11 (2) 165-186.

Rapport, F., Doel, M.A., Hutchings, H.A., Wright, S., Wainwright, P., John, D.N. & Jerzembek, G.S. (2010). Eleven themes of patient-centred professionalism in community pharmacy: innovative approaches to consulting. International Journal of Pharmacy Practice 18 (5) 260-268.

Blenkinsopp, A., Bond, C., Gianpiero, C., Inch, J. & Gray, N. (2009). National evaluation of the new community pharmacy contract, p. 264. London: Pharmay Practice Research Trust.

Community Pharmacy Scotland. NHS Care Services: Public Health Service. 2012; Available from:



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