From Discourse to Practice-Facilitating Factors and Barriers to the Implementation of Pharmaceutical Care in Primary Health Care: A Qualitative Study.

Abstract

Background: The implementation of pharmaceutical care (PC) in Primary Health Care (PHC) faces challenges related to interprofessional integration, management support, and infrastructure, despite its potential to improve patient-centered care.

Objectives: To analyze, from the perspective of pharmacists working in PHC, the facilitating factors and barriers to the implementation of PC in the public health system in a post-implementation context.

Methods: This is a qualitative, exploratory study, with eight individual semi-structured interviews conducted remotely between December 2024 and February 2025. The interviews were recorded, transcribed, and subjected to thematic content analysis by a trained team, with peer validation.

Results: The main facilitators identified were: a solid relationship with the team, participation in continuing education, and a bond with patients. Barriers included a lack of adequate infrastructure, workload, staff turnover, and resistance from the health team. Management support, although frequently cited as a facilitator, did not always translate into concrete actions for service implementation. Even in the face of these barriers, the implementation of PC contributed to strengthening patient-centered care, the clinical protagonism of pharmacists, and improving health outcomes.

Conclusions: The analysis highlighted that the sustainability of PC depends on structural and relational conditions that go beyond individual training. The study reveals that, after implementation and continuing education processes, organizational barriers persist that limit the consolidation of PC, highlighting the need for institutional policies and ongoing management support to effectively integrate pharmacists into healthcare.