OBJECTIVES: To understand healthcare professionals' experiences and perceptions of nurses' potential or ideal roles in pharmaceutical care (PC). DESIGN: Qualitative study conducted through semi-structured in-depth interviews. SETTING: Between December 2018 and October 2019, interviews were conducted with healthcare professionals of 14 European countries in four healthcare settings: hospitals, community care, mental health and long-term residential care. PARTICIPANTS: In each country, pharmacists, physicians and nurses in each of the four settings were interviewed. Participants were selected on the basis that they were key informants with broad knowledge and experience of PC. DATA COLLECTION AND ANALYSIS: All interviews were conducted face to face. Each country conducted an initial thematic analysis. Consensus was reached through a face-to-face discussion of all 14 national leads. RESULTS: 340 interviews were completed. Several tasks were described within four potential nursing responsibilities, that came up as the analysis themes, being: 1) monitoring therapeutic/adverse effects of medicines, 2) monitoring medicines adherence, 3) decision making on medicines, including prescribing 4) providing patient education/information. Nurses' autonomy varied across Europe, from none to limited to a few tasks and emergencies to a broad range of tasks and responsibilities. Intended level of autonomy depended on medicine types and level of education. Some changes are needed before nursing roles can be optimised and implemented in practice. Lack of time, shortage of nurses, absence of legal frameworks and limited education and knowledge are main threats to European nurses actualising their ideal role in PC. CONCLUSIONS: European nurses have an active role in PC. Respondents reported positive impacts on care quality and patient outcomes when nurses assumed PC responsibilities. Healthcare professionals expect nurses to report observations and assessments. This key patient information should be shared and addressed by the interprofessional team. The study evidences the need of a unique and consensus-based PC framework across Europe.

ANASTE Humanitas Foundation Rome Italy

Department of Nursing and Clinical Science Bournemouth University Bournemouth England United Kingdom

Department of Nursing Faculty of Health Sciences University of Alicante Alicante Spain

Department of Nursing Laboratory of Integrated Health Care University of Peloponnese Sparti Greece

Department of Nursing Swansea University Swansea Wales United Kingdom

Faculty of Health and Welfare Østfold University College Halden Norway

Faculty of Health Sciences Department of Nursing University of Primorska Izola Slovenia

Faculty of Medicine and Health Sciences University of Antwerp Antwerp Belgium

Faculty of Nursing and Professional Health Studies Slovak Medical University in Bratislava Bratislava Slovak Republic

Health Sciences Research Unit Nursing Coimbra Portugal

Institute of Nursing Sciences Basic Health Sciences and Health Visiting Faculty of Health Sciences University of Pécs Pécs Hungary

Institute of Nursing Theory and Practice 1st Faculty of Medicine Charles University Prague Czech Republic

Medical Faculty Institute of Health and Nursing Science Martin Luther University Halle Wittenberg Halle Germany

Research Group Care for the Chronically Ill University of Applied Sciences Utrecht Utrecht The Netherlands

University St Kliment Ohridski Bitola Bitola Republic of North Macedonia

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