Evolution of community pharmacists’ roles and adaptation strategies: A qualitative study in Auvergne-Rhône-Alpes

Abstract

Introduction: In the context of increasing pressure on the healthcare system, the role of community pharmacists in France has undergone rapid reconfiguration. This qualitative study explored pharmacists’ perceptions of ongoing transformations, highlighting areas of engagement, constraints, and adaptation strategies.

Methods: Thirty semi-structured interviews were conducted between September and December 2024 with community pharmacy owners in the Auvergne-Rhône-Alpes region. A purposive sampling strategy ensured diversity in terms of geographical location, pharmacy structure, and professional seniority. Thematic analysis was performed and continued until data saturation was reached.

Results: Participants described an expansion of professional roles (vaccination, medication reviews, screening services), perceived as professionally rewarding but hindered by administrative overload, lack of institutional recognition, and interprofessional tensions. Limited digital interoperability, economic concentration, and stagnant profit margins were identified as factors threatening the sustainability of pharmacies, particularly independent ones. Testimonies revealed a sense of loss of meaning (“I spend more time filling out forms than talking to patients”) and significant uncertainty about the future (“Every year, new responsibilities are added without knowing whether they will be sustainable or properly remunerated”). Despite these challenges, adaptive dynamics emerged, based on service diversification, organizational innovation, and strong territorial integration.

Discussion: This study highlights a profession at a turning point: increasingly involved in primary care, yet insufficiently supported at the institutional level. A sustainable transition of the community pharmacy model will require political, economic, and structural support commensurate with the scale of the transformation underway.