Community pharmacists’ views on the factors influencing prescription medication side effect counselling: a qualitative interview study

Introduction Community pharmacists play a crucial role in medication counselling, which includes side effect counselling (SEC), helping support informed decision-making, patients’ adherence, and medication safety. Despite its recognised importance, deficiencies in SEC provision have been reported, and limited research has investigated the behavioural determinants underpinning pharmacists’ SEC practices. Aim This qualitative study aimed to explore community pharmacists’ views on the factors influencing prescription medication SEC. Method Semi-structured interviews were conducted with community pharmacists in Ireland. Transcripts were analysed using conventional content analysis and directed content analysis by using the Theoretical Domains Framework (TDF). Predominant domains were determined based on the frequency of the beliefs, presence of conflicting beliefs, and perceived strengths of those beliefs. Results From eleven interviews, six predominant TDF domains were identified in influencing SEC provision: environmental context and resources, social professional role and identity, memory, attention and decision-making, skills, beliefs about consequences, and social influences. While SEC was considered a core professional responsibility, time pressures and workload were dominant environmental barriers. Pharmacists employ cognitive heuristics to prioritise SEC for new and high-risk medications and tailor their language and information quantity based on patients’ health literacy and emotional state to balance the need to inform against the risk of hindering adherence by overwhelming patients—skills which they believed they refined with experience. Conclusion This study provides unique insights into the behavioural determinants influencing pharmacist SEC. The findings offer a foundation for developing targeted interventions to enhance SEC in community pharmacy, ultimately helping to improve patient safety and therapeutic outcomes.