Make Workshop Pharmacy Experience – Participant 3

Method Overview

This was a primary research method in which the participant was given a toolkit via Miro, to create their current pharmacy experience. The participant then mapped their current experience from medication prescription to pickup and then to refill. 

Prompt

Step 1 / 10 mins
Create your CURRENT Pharmacy experience from medication prescription to pick up and then to refill. Use the talk out loud method as you do this.
Step 2 / 10 mins
Then, explain your CURRENT Pharmacy experience.
Step 3 / 5 mins
Then look at your CURRENT Pharmacy and tell me how you would change it to be an IDEAL Pharmacy experience.

Results

The Participant’s Talk Out Loud Transcript & Explanation of the Map

• I start at my house, where I call in my prescription. The issue I’ve been having lately is that I’m not taking medication from bottles anymore. I’m getting needles and strips. So I can never find the Rx number. So what I have to do now is call my pharmacy and describe what I need. Which they should have in the system listed under me, but they don’t. So I’ll say I need more needles for my shots, they’ll ask what size, and I’ll say I don’t know. The other day they gave me the wrong size, because I didn’t know how to describe it and didn’t have the size written on the shot. The problem is that it says it on the white prescription bag they come in. I typically always throw that away. I keep running into this problem where my muscle memory causes me to throw away the bag, but the bag has my Rx number for my shots. This is a new medication that I will be on for the rest of my life, so it’s been a bit of a learning curve to remember to keep the bag.
• Then I would go to the pharmacy. I go to Kroger. Usually a line. I’ve waited 40 minutes before.
• I will wait in line, then get up there and it’s still not ready so I have to wait longer. The problem is that I will get a text saying my prescription is ready, then I go up in line expecting it to be ready, and it’s not. This is frustrating because they tell me to shop around, but I already shopped around until I got the text…so I have to wait longer. I wish there was some sort of tracker?
• When in line getting my medication, I will pick up prescriptions for other people I know who need it just with their name and date of birth. I don’t know how I feel about that. On one hand it’s really convenient, on the other it kind of scares me that that’s all you need. They don’t even check your ID.
• I don’t ask the pharmacist questions. Half the time I don’t even know what I’m doing. I give them my name and DOB, and they give me options for my medication. I don’t know what I need? I don’t know what the medication is called really, because they use different names for the same thing. The other day I was in the drive through and they held something up to the camera, and they asked if it looked right. In my head I was thinking…I don’t know because I really couldn’t see it well, but I said yes and when I got home it was wrong. It was raining outside, I needed to physically see it to be sure that it was the right thing.
• There’s this feeling when I go to the pharmacy that i’m kind of winging it and relying on what it says on my past prescription as the right thing I need. The thing is, they always forget to give me something because my medication is so complex. They’ve forgotten to give me my needles for my shots or given me the wrong size thing, and this was a problem because last time I needed that medication and I had to get it out of town as an emergency prescription because I didn’t check the bag to see if it was all there until I was about to take it.
• Another issue is that I don’t ever know how much it is going to cost. Sometimes I will go and the cost will be an unexpected amount. This causes me anxiety.
• The other thing that really bothers me is that this prescription will be for the rest of my life. But I will call them to get a refill and the pharmacist will say that the prescription ran out and they need to contact my doctor to get a new prescription. If I’m going to take this medication for the rest of my life…why do I have to contact my doctor? My dad has the same condition that I have, and he is considering getting his medication mailed to him through good Rx online so that it is delivered to him (without even getting insurance to cover it) because he is so frustrated with this process too. The double standard is that if I call it in too early, they will ask me why I want the refill so soon. They will also then say it’s not ready. So if I am too early I can’t get it, and if I’m too late I can’t get it. This is something I need, and I want to get it on my own time.
• Bottom line is that they can’t mess up because I need the medication tonight or tomorrow. It can’t take a week after I call to get it because they gave me the wrong needles. I can’t skip that medication for a week. This causes so much anxiety for me.
• There has been medication before where I didn’t know how to take it and I never ask the pharmacists. If I do, they give me really short or generic answers. A past medication I had caused me to take it twice a day with meals, and I really didn’t know what counted as a “meal.” All the pharmacist said was “take it twice a day with meals.” Sometimes I eat a big lunch and will have a snack later for dinner, does that count as a meal? I called my doctor to figure this out. I don’t really like my doctor, too, so I just feel like i’m not getting really good information from anyone…so I just wing it.

Q&A After the Explanation

[The participant had a stroke two summers ago as a side effect of their birth control medication and wanted to share their experience with that here.]

Researcher: Did any healthcare expert you saw ever tell you that a stroke was a potential side effect for the birth control pill that you were on?

• No, never. I started to take this birth control for my skin. That’s why the put me on it. I had no idea it affected your hormones so much. I’ve heard from my friends you can get depression, weight gain, it can make your periods worse…so why did my doctor put me on it for my skin? And why did I not know about these side effects? I don’t think there’s a lot of education with birth control in general because when I used to take it I would take it at different times every day…I didn’t really know how much that mattered so long as it was within a few hours. I’d get worried, asking myself if I was doing this right. I had no idea you could get a stroke from it at all, no idea that I even needed to be looking out for that.
• For my stroke, when I was experiencing my first symptoms they were excruciating migraines that lasted for months. I was also feeling like it was really hard to focus. When I went to the ER for this, they never batted an eye at the current medication I was taking to see if that was what was causing it. They just gave me really strong Advil and sent me on my way. In the ER I would sit there for 6 hours before they ever did anything. They would not listen to me when I said the Advil did not work and that I was in so much pain it was hard to get out of bed, concentrate, or even drive. Which I did a few times before the buildup of my stroke.
• A lot of other girls I know got off of their birth control once they heard my story. They also did not know that stroke was a symptom until they heard my story and looked up the symptoms on their own medication. 
• The problem is, that birth control was my first long term prescription medication. I was not told anything about symptoms. It was simply “we’re gonna give you this, go get it from the pharmacy.” I felt like there was a ton of miscommunication. I was not taught how to schedule a refill for my medication, it feels like the healthcare system just expects you to “figure it out.” 

Researcher: What would you change for this to be an IDEAL pharmacy experience?

• They need more than 1 line. I’m not going to ask questions in line if there are 9 people behind me.
• I also did not really know that you could talk to the pharmacist about medicine. They usually don’t have personalities that are approachable. It would be nice to have someone to sit down and talk with. Maybe there is a way to educate that to people. Like, can you call them? Is there a text service to reach out to them if you have questions? Because I have a lot of questions about my medicine, and I don’t really like my doctor so it would be nice to have someone else to ask.
• I want ways to be able to reach out to my pharmacist without going to the pharmacy too. A lot of times when I go to the pharmacy my mind is in so many places because I am out running errands. I may forget to ask questions or just not want to ask because I’m in a rush.
• There are a lot of parts to the pharmacy that could be improved. I had no idea that there was a whole section in the pharmacy for diabetics. It would have been nice to know.
• I think it would be nice if the pharmacy had an easier process so that we could ask questions more. I wish it was more widely known or widely pushed that they can assist you with other health issues.
• I also have no idea what medication can be paired, and I even know that some over the counter medication cannot be paired. So I hate the over the counter aisles because I just get so worried about mixing. I don’t know the difference about anything. It would be nice if the pharmacist could help you navigate those isles or help pair your over the counter meds with my prescription meds.
• My partner doesn’t have a doctor, and he will wait until it it is major to get something checked out. Most of the time he will just go to the  pharmacy for really bad stomach pain, when I tell him he should go to the doctor. But he feels like it isn’t a big deal, and it’s such a hassle go to the doctor that he’d rather just get a quick fix from an over the counter medication. Most people don’t really go to the doctor until something gets really really bad. We don’t even really go to checkups. But if we did, we could catch stuff earlier. I wish there could be an easier way for him to slip in speak to an expert and say that he’s experiencing these stomach pains to see what they should recommend he do. Can the pharmacy do that? Could the pharmacist recommend something OTC and if it doesn’t go away within a certain time they could suggest us to see a doctor?
• I did the same thing where when I was getting headaches from a stroke (blood clot in my brain) from my birth control I did not see the doctor until it became unbearable. 

Analysis:
Overall, this study provided really great insight because this person pointed out a few key issues. First, going to the pharmacy feels more technical than medical. Prescriptions are the last step in the care process for patients, so it almost feels like it’s all about going and grabbing the thing you need. It seems that there are so many technical steps in the prescription pickup process (waiting in line, giving them your name, DOB, telling them the Rx Number, waiting, and paying) that a person is not thinking about the care aspect of the medication they are getting until they get home. The prescription pickup process creates anxiety because it’s so complex and is dealing with money and a line. What is also interesting is that the pharmacy is the last step, but it can also be the first step in seeking care. The participant points out that they wish they could go to a pharmacist with an issue to see what they should do next, but their process is always so messy that they never do that or don’t know that they can.

Cover Image Source: Freepik