PhD defence R. (Roland) te Paske

Building bridges for trust

Strengthening patient-centred communication in pharmacy for optimal inhaler use in asthma and COPD patients

In the Netherlands, over 1.5 million people with asthma and/or COPD use inhalation medication. Nearly 70% do not use this medication as prescribed, due to both poor adherence and incorrect inhalation technique. The pharmacy team—often the last healthcare provider patients see before starting treatment—plays a key role in informing and supporting patients in the correct use of their medication. This role aligns with the pharmacy’s shift from product provision to patient-centered care.

This dissertation explores the role of trust in medication and healthcare providers, and pharmacy technicians’ confidence in delivering patient-centered care. It aims to (1) provide insight into how trust and self-confidence affect medication use, and (2) support pharmacy technicians in improving communication skills, especially for consultations with asthma and COPD patients.

A video-feedback-based training program, COM-MA, was developed and positively evaluated. A follow-up, On TRACk, expanded this with inhaler instruction and showed improvements in technicians’ communication confidence—especially among less experienced staff.

The On TRACk intervention was tested in a pilot study. Despite implementation challenges, the approach was seen as valuable. Lessons learned included the need for realistic planning, strong local leadership, and reduced workload for participating teams.

Trust is essential for effective patient communication in pharmacies. Investments in personalized care, improved training, and better use of technology can enhance adherence and outcomes. Future research should focus on hybrid and practice-integrated studies to ensure effective implementation of interventions like On TRACk in real-world settings.

Supervisors:      prof. dr. ir. C.E.M.J. (Liset) van Dijk, dr. J.F.M. (Job) van Boven
Co-supervisors: dr. M. Vervloet, dr. A.J. Linn