Bridging gaps in medication therapy management at community health centers: A mixed-methods study on patient perceptions and pharmacists' preparedness.

Background: The primary goals of Medication Therapy Management (MTM) are to avoid pharmaceutical mistakes, facilitate accessible therapy, and encourage patients to actively participate in their health management. Objectives: This study aimed to determine patients' perceptions of MTM services, evaluate the knowledge, attitudes, and practices (KAP) of Community Health Center (CHC) pharmacists regarding MTM services, and develop strategies to improve MTM services in CHCs. Methods: A mixed-method approach was designed in three parts. First, a study was conducted with diabetic or hypertensive patients at CHCs around Yogyakarta to assess their perceptions of MTM elements and benefits. Second, a survey was conducted among CHC pharmacists to determine their KAP concerning MTM and the current service provided. In the third part, findings from the second stage were used to establish appropriate MTM services for CHCs through focus group discussions (FGDs) and to explore obstacles to implementation. Qualitative data were analyzed using inductive content analysis. Results: Among 117 patient participants, over 60.0 % perceived positive benefits from five elements of MTM. Among 37 pharmacist participants, 19 (51.4 %) of them did not understand MTM concepts, with 14 (37.9 %) pharmacists demonstrating a low level of knowledge. Nearly all pharmacists held a positive attitude towards MTM. Time constraints were identified as barriers to MTM implementation. Based on the FGD with 24 pharmacists, three main themes and ten sub-themes were identified. Conclusions: MTM services have not been fully implemented by pharmacists at CHCs. Future implementation of MTM is expected to be more adaptive to the CHCs condition, integrated with existing systems, standardized in terms of procedures and facilities.