1 However, raising public awareness of the HLP brand and signposting more patients to HLPs at GP surgeries may bring even greater benefits. These findings support continued national roll-out of the initiative.

1. NHS Portsmouth (2010) Healthy Living Pharmacies: Next Steps – Delivering Sustainable Quality. Online document available from: http://www.portsmouth.nhs.uk/Downloads/Healthy%20Living%20Pharmacy%20Next%20Steps.pdf learn more (Last accessed: 26/04/2013) 2. Pope C, Ziebland S, Mays N. Qualitative research in healthcare: Analysing qualitative data. British Medical Journal 2000; 320: 114–116. Nadya Iqbal, Paul Rutter Wolverhampton University, Wolverhampton, UK How do community pharmacists make decisions when attempting to make a diagnosis? Pharmacists relied heavily on using WWHAM Pharmacists did not demonstrate any clear use of clinical reasoning Government healthcare policy now places greater emphasis on patient self-care exemplified by the increased number of prescription only medicines deregulated for sale as over-the-counter medicines. Pharmacists are now custodians of an expanding range of increasingly potent medicines to treat a growing list of medical conditions. However research to date has not established the decision-making process of pharmacists when making diagnoses. This exploratory study looked at the ways in which

community pharmacists go about making a diagnosis. The think-aloud technique was used to explore the cognitive decision-making processes used by community pharmacists PD98059 order when making a diagnosis in response to a patient request. This method is often used to describe also the sequence of thoughts behind decision-making by asking participants to say their thoughts whilst performing a task (responding to a patient scenario). [1] A scenario was devised where by a patient (in this instance the interviewer) presented to the pharmacist with headache. Headache was chosen as the symptom under investigation as multiple causes can account for headache. Standardised

replies were constructed to ensure the same response was given during each think-aloud session with the pharmacist. A panel of 3 experienced pharmacists was selected to review the case to ensure the standardised replies were relevant and appropriate. The scenario was designed to represent sub-arachnoid haemorrhage. To ensure the researcher (NI) performed consistently and was able to use the think-aloud technique, the scenario was role-played with members of academic pharmacist staff prior to data collection. Pharmacists from two co-terminus National Health Service boundaries in the Midlands region of England were invited take part in the study. The area sampled was one of geographical convenience to the researcher (NI). Prior to the interview taking place written consent was gained from each interviewee. Each interview was transcribed verbatim and analysed in iterative cycles allowing major themes to be developed.