Exploring Opportunities for Improving Pharmacy Services for People With Disabilities: A Qualitative Study
Abstract
Background: People with disabilities face significant barriers to accessing pharmacy services, including physical inaccessibility, communication challenges, and inadequate pharmacist training. These barriers often result in poor healthcare outcomes, which lead to a decline in the provided services.
Objective: To explore hospital pharmacists’ experiences, challenges, and suggestions for improving pharmacy services for individuals with disabilities in Saudi Arabia.
Methods: A qualitative study was conducted using semistructured interviews with fifteen hospital pharmacists selected through purposive sampling. Participants had to have had at least 5 years of experience and direct interaction with disabled patients. Data were transcribed verbatim and analyzed using thematic analysis to identify recurring themes and insights. An inductive thematic analysis approach was employed.
Results: The analysis revealed five key themes: (1) physical inaccessibility of pharmacy infrastructure, (2) communication barriers, (3) training needs, (4) the role of assistive technologies, and (5) proposed service improvements. Technology was recognized as a facilitator, with tools such as Braille medication labels, automated dispensing systems, and mobile health applications identified as potential solutions. Participants also proposed structural modifications, mandatory training programs, and dedicated service pathways to address identified challenges. These findings highlight the importance of a comprehensive approach that integrates infrastructure redesign, targeted training, technological solutions, and inclusive healthcare policies.
Conclusion: Improving pharmacy services for individuals with disabilities requires structural, educational, and technological interventions to enhance accessibility, communication, and service delivery.
Implications for Research and Practice: The findings of this study provide valuable insights into the barriers faced by individuals with disabilities when accessing pharmacy services and offer actionable recommendations for improvement. From a practical perspective, healthcare institutions should prioritize mandatory disability-awareness and communication training programs for pharmacists, focusing on skills such as sign language, assistive technology use, and inclusive communication strategies. Structural modifications to pharmacy infrastructure, including lowered counters, wider aisles, and accessible shelving, are essential to ensure physical accessibility. In addition, the integration of assistive technologies, such as Braille labels, voice-assisted mobile apps, and automated dispensing systems, can help address communication gaps and improve medication adherence. Dedicated service pathways for patients with disabilities can further enhance privacy, reduce waiting times, and ensure personalized care delivery. From a research perspective, future studies should explore the perspectives of patients with disabilities to complement pharmacists’ insights, employ mixed-methods approaches for a more comprehensive understanding, and conduct longitudinal studies to evaluate the long-term effectiveness of training programs and technological interventions. Cross-cultural comparative studies can also help identify universal challenges and region-specific solutions. By addressing these implications, stakeholders—including healthcare institutions, policymakers, and educators—can collaboratively create a more inclusive, accessible, and equitable pharmacy service environment for individuals with disabilities.
1. Introduction
People with disabilities face unique challenges in accessing healthcare services, including pharmaceutical care services [1, 2]. These challenges can range from physical barriers to communication issues, and they often result in suboptimal healthcare outcomes [3, 4]. Pharmaceutical care services are a critical component of healthcare delivery, as they involve providing medications, counseling, and other support to patients [5–7]. For individuals with disabilities, the ability to access and utilize these services effectively is vital [8, 9]. For instance, visually impaired patients may struggle with reading medication labels, while hearing-impaired individuals face communication challenges when pharmacists lack sign language skills [10–12]. However, existing healthcare systems, including pharmacy services, often fail to meet their needs due to a lack of awareness, inadequate infrastructure, and insufficient training for healthcare providers [2, 13, 14].
Data on the prevalence and distribution of various types of disabilities in Saudi Arabia are based on a report by the General Authority for Statistics [15]. Mobility-related disabilities emerged as the most prevalent, affecting 1% of the total population and accounting for 51.8% of all individuals with disabilities. Communication and visual disabilities were the second most common, each with a prevalence of 0.6% among the total population and representing 33.4% and 30.9% of individuals with disabilities, respectively. Self-care disabilities constituted 0.5% of the population and 26.8% of those with disabilities, while cognitive disabilities accounted for 0.4% and 22.2%, respectively. Hearing disabilities were the least prevalent, affecting 0.3% of the population and 14.3% of individuals with disabilities [15]. These findings confirmed the need for dedicated support and resources to address the varying needs of individuals with different types of disabilities in Saudi Arabia. Percentages represent the proportion of the specified group within the total population tabulated in Table 1. The results indicate that the prevalence rates of disabilities vary by type, ranging between 0.3% and 1.0%. The distribution of disabilities by type in 2022, based on data derived from the classifications used in the disability statistics report, is presented in Table 2.
| Category | Percentage of total population (%) | Details |
|---|---|---|
| Individuals with at least one physical difficulty or mild disability in Saudi Arabia | 5.9 | Includes all residents of Saudi Arabia. |
| Individuals with at least one physical difficulty or mild disability (Saudi nationals) | 4.2 | Includes Saudi nationals only. |
| Individuals with mild physical difficulty (Saudi nationals) | 2.8 | Includes Saudi nationals only. |
| Individuals with mild physical difficulty (non-Saudis) | 1.3 | Non-Saudis residing in Saudi Arabia. |
| Individuals with mild physical difficulty (total population) | 3.8 | Includes both Saudis and non-Saudis. |
| Individuals with mild physical difficulty (males) | 2.6 | Males in Saudi Arabia. |
| Individuals with mild physical difficulty (females) | 3.0 | Females in Saudi Arabia. |
| Individuals with at least one disability (total population) | 1.8 | Includes all residents of Saudi Arabia. |
| Individuals with at least one disability (Saudi nationals) | 2.7 | Includes Saudi nationals only. |
| Individuals with at least one disability (non-Saudis) | 0.6 | Non-Saudis residing in Saudi Arabia. |
| Individuals with at least one disability (males) | 1.6 | Males in Saudi Arabia. |
| Individuals with at least one disability (females) | 2.1 | Females in Saudi Arabia. |
| Most common disabilities in Saudi Arabia | ||
| Mobility-related disability | 1 | Most prevalent type of disability in Saudi Arabia. |
| Visual impairment and communication disabilities | 0.6 | Second most common types of disabilities in Saudi Arabia. |
- Note: Source: General Authority for Statistics, 2022.
| Disability type | Number of cases | Prevalence (%) among total population (%) | Percentage of individuals with disabilities (%) |
|---|---|---|---|
| Mobility related | 304,787 | 1 | 51.8 |
| Communication | 196,611 | 0.6 | 33.4 |
| Visual | 181,728 | 0.6 | 30.9 |
| Self-care | 157,977 | 0.5 | 26.8 |
| Cognitive | 130,820 | 0.4 | 22.2 |
| Hearing | 84,025 | 0.3 | 14.3 |
- Note: Source: General Authority for Statistics Report, 2022.
Research on disability-inclusive healthcare has primarily focused on broader systemic challenges, with limited attention given to the specific role of pharmacists. However, as frontline healthcare providers, pharmacists are uniquely positioned to address some of the barriers faced by people with disabilities.
This study aims to fill this gap by examining the experiences and insights of hospital pharmacists regarding the improvement of pharmacy services for individuals with disabilities. By identifying the challenges and opportunities in this area, the findings can inform targeted interventions and policy changes to promote inclusivity and equity in pharmacy care.
While several studies have explored barriers to accessing healthcare for people with disabilities, few have specifically examined the role of pharmacists, particularly within the Saudi healthcare context. Much of the existing literature focuses on physicians or general healthcare systems, leaving a significant knowledge gap regarding pharmacists’ perspectives. This study addresses that gap by presenting context-specific insights from Saudi hospital pharmacists, thereby contributing novel, profession-specific findings to the disability and pharmacy literature.
2. Methods
Study design and sampling: this qualitative study utilized semistructured interviews to collect in-depth insights from hospital pharmacists about their experiences and perspectives. The sample size was determined based on the principle of thematic saturation, the point at which no new themes or insights emerged from the data. Saturation was monitored throughout the interview process, and after the twelfth interview, responses began to repeat, and no substantially new information was identified. By the fifteenth interview, the research team agreed that thematic saturation had been achieved.
Participants: fifteen hospital pharmacists who met the inclusion criteria were invited by email, which was distributed via hospital administration offices. The invitation email included details about the study, participation requirements, and contact information for the research team. Those who expressed interest were provided with a participant information sheet and consent form before scheduling the interview. Inclusion criteria were at least 5 years of experience in a hospital pharmacy and direct interaction with patients, including individuals with disabilities.
Data collection: semistructured interviews were conducted either in person or via a written interview format. An interview guide with open-ended questions was used to explore the participants’ experiences, challenges, and recommendations for improving pharmacy services. Basic demographic data were collected from each participant, including age, gender, years of professional experience, and current practice setting. This information was obtained to provide context for the participants’ responses and to ensure diversity in perspectives. Collecting demographic data also allowed the researchers to explore potential variations in viewpoints based on experience level and work environment, thereby enhancing the credibility and transferability of the study findings.
Data analysis: interviews were transcribed verbatim and analyzed using thematic analysis. Two researchers independently coded the data, and discrepancies were resolved through discussion. Key themes were identified and organized to address the study objectives. The analysis followed Braun and Clarke’s six-step approach to thematic analysis. Coding was conducted manually by two researchers. Transcripts were first read and re-read for familiarization, followed by inductive coding. Themes were refined through researcher discussions and consensus. Credibility was ensured through independent coding and audit trails, while transferability was enhanced by including participants from multiple hospital settings. Interviews were conducted by the principal investigator NA, who also participated in the data analysis along with FA. Both are trained in qualitative research and independently coded the data before reaching thematic consensus.
3. Results
The analysis of the qualitative responses revealed five key themes: challenges faced by patients with disabilities; pharmacists’ training needs; communication barriers; the role of technology; and proposed improvements for pharmacy services tailored to individuals with disabilities. The thematic analysis identified recurring issues and suggested actionable solutions to address them.
3.1. Theme 1: Challenges Faced by Patients With Disabilities
The findings revealed that individuals with disabilities faced significant challenges when accessing pharmacy services. One of the most prominent barriers identified was physical inaccessibility, with pharmacy counters and medication shelves often being out of reach for wheelchair users. This physical barrier limits patients’ independence and often forces them to rely on caregivers or pharmacists for assistance. In addition, communication barriers emerged as a significant concern.
“The pharmacy counter is far from patients using wheelchairs, and there is no designated space for them to wait.” (P1)
“The pharmacy is located on the first floor, which increases the time required to access it via elevator. There’s also no waiting area for patients in wheelchairs.” (P11)
“Some patients with disabilities don’t know what services are available to them or how the pharmacy will handle their specific condition.” (P4)
Collectively, these accounts underscore the importance of improving both the physical layout and communication strategies within pharmacy services to ensure accessibility and equity for patients with disabilities.
3.2. Theme 2: Training Needs for Pharmacists
“Training at least one staff member in sign language is essential, along with having a device that prints instructions in Braille.” (P1)
“Sign language.” (P2, P3, P10)
“Pharmacists need training in disability awareness, communication skills, accessibility standards, empathy, and assistive technologies to provide inclusive care.” (P7)
“Effective communication techniques and understanding how to deal with the challenges associated with various disabilities should be core components of pharmacist training.” (P4)
“Understanding the needs of patients with disabilities based on their cultural and social background—especially in how they perceive and deal with their condition—is crucial. This includes sign language and appropriate explanation techniques.” (P11)
“Attending workshops and training programs focused on dealing with hearing-impaired patients and learning sign language.” (P5)
“An intensive academic program is needed to raise awareness on how to interact with individuals with disabilities.” (P14)
Overall, the responses revealed a clear demand for formal, competency-based training that combines technical, interpersonal, and cultural skills to ensure inclusive pharmacy services.
3.3. Theme 3: Communication Barriers
Communication challenges were consistently highlighted by pharmacists, particularly when interacting with patients with visual, auditory, or cognitive disabilities. Many described the lack of standardized tools or strategies to bridge these gaps and emphasized the need for adaptable, patient-centered approaches.
“For visual disabilities, I provide written instructions in large print or Braille.” (P7)
“There should be labels in Braille or barcodes that link to audio recordings of medication instructions.” (P3)
“We need to train pharmacists in sign language and provide audio-visual materials containing medication information for patients with visual disabilities.” (P2)
“For hearing barriers, we confirm the patient’s understanding and review the instructions with them again.” (P3)
“We usually communicate through the patient′s caregiver, or provide written instructions when appropriate.” (P5)
“For patients with cognitive impairments, we offer simplified explanations and repeat key information, sometimes using visual aids to reinforce understanding.” (P7)
“There should be a clear way to request communication assistance in advance—without delay—through the hospital system.” (P4)
“It’s crucial to have a family member accompany the patient to ensure the information is properly delivered.” (P10)
Collectively, these quotes emphasize the urgent need for tailored communication strategies, training in alternative communication methods, and improved infrastructure to support diverse patient needs in pharmacy settings.
3.4. Theme 4: Role of Technology in Improving Pharmacy Services
Pharmacists widely recognized the potential of technology as a powerful enabler of accessibility and communication for individuals with disabilities. Many participants suggested innovations that could transform how medication information is delivered and understood.
“Technology could translate speech into sign language and print medication instructions in Braille.” (P1)
“Using automated dispensing machines with Braille options and audio guidance could help patients with visual impairments.” (P2)
“Technology can help patients understand medication labels, names, expiry dates, and instructions using apps or AI tools that speak to them directly.” (P3)
“QR codes on medication packaging could link to videos in sign language to guide patients.” (P5)
“Technology could reduce the need for patients to visit the pharmacy by offering mail delivery services and virtual counselling clinics.” (P12)
“I don’t think technology plays a role here. These situations need a specialist with deep human empathy.” (P4)
“Technology can play a crucial role by offering tools like Braille labels, screen readers, mobile apps, and audio dispensers to support communication and medication management.” (P7)
Together, these perspectives reveal both enthusiasm for and thoughtful reflection on the integration of digital tools to address access and communication barriers in pharmacy practice.
3.5. Theme 5: Proposed Improvements for Pharmacy Services
Pharmacists proposed a variety of initiatives aimed at creating a more inclusive and accessible pharmacy environment for individuals with disabilities. Suggestions spanned across infrastructure, staff development, communication tools, and technology integration.
“Install service windows at the height suitable for wheelchair users, and spend more time with them during consultations to ensure treatment adherence.” (P6)
“There should be a dedicated service path for patients with disabilities.” (P2)
“All staff should be required to attend mandatory training workshops on how to interact with patients with disabilities.” (P5)
“Training programs on disability awareness should be implemented for all healthcare professionals, including those in pharmacy services.” (P13)
“We need to integrate modern technologies and artificial intelligence to make it easier for patients with disabilities to understand their medications.” (P3)
“Using tools like Braille instructions and audio guidance can support communication. We should also develop clear pharmacy policies that prioritize personalized care for these patients.” (P7)
“For patients who cannot reach the hospital, it’s important to include a pharmacist in home care teams to offer medication counselling and ensure proper usage.” (P13)
“We should raise awareness and increase visibility through participation in international days and campaigns.” (P9)
These proposals reflect a significant understanding of the diverse needs of people with disabilities and underscore the necessity for targeted policy changes, system-wide training, and patient-centered design in pharmacy practice.
4. Discussion
Previous studies have similarly emphasized the importance of assistive communication tools and pharmacist training in improving interactions with disabled patients [16, 17]. Implementing userfriendly communication technologies, such as mobile health apps with voice commands, could significantly enhance pharmacist–patient communication and reduce reliance on caregivers. For example, voice-assisted mobile apps could guide visually impaired patients through their medication instructions, while barcode-scanning technologies could provide audio instructions for each medication. These findings are consistent with global healthcare trends, where digital health solutions have been successfully integrated into pharmacy services to improve patient autonomy and reduce dependency on caregivers [18–20]. For instance, research from Ethiopia and Europe revealed comparable gaps in pharmacist training regarding communication with patients with hearing and visual impairments. In addition, the role of mobile health technologies and assistive tools, as emphasized in this study, mirrors trends observed in global healthcare systems. However, the effectiveness of these technologies relies on ensuring they are userfriendly and accessible to individuals with varying levels of digital literacy.
Our study demonstrated that pharmacists reported difficulties with communicating with patients who have hearing, speech, or cognitive impairments due to their lack of training in sign language or the absence of assistive communication tools. These findings align with existing literature, which highlights architectural and communication barriers as key obstacles to healthcare access for individuals with disabilities [2]. Addressing these challenges requires the implementation of universal design principles in pharmacy layouts, along with targeted communication training programs for pharmacists.
Research supports these findings, showing that well-structured training programs not only improve pharmacist confidence but also enhance patient satisfaction and health outcomes [21–23]. Moving forward, mandatory training initiatives should be incorporated into pharmacy education curricula to ensure that pharmacists are equipped with the necessary skills and knowledge [24–26].
The General Authority for Statistics in Saudi Arabia highlights that the total number of individuals in Saudi Arabia with at least one physical difficulty or mild disability reached approximately 1.35 million people, representing 4.2% of the total population. Among them, 1.112 million individuals are Saudi nationals, accounting for 5.9% of the Saudi population, while the number of non-Saudis with such conditions was approximately 238,000, representing 1.8% of the non-Saudi population. Gender wise, 765,000 males (3.9% of the total male population) and 585,000 females (4.7% of the total female population) were included. Of these, 588,000 individuals had at least one disability, while 891,000 individuals reported at least one mild physical difficulty, accounting for 2.8% of the total population [15].
4.1. Strengths and Limitations
The qualitative approach provided in-depth insights into pharmacists’ experiences and perspectives. Recommendations derived from participants’ experiences offer practical solutions for policy and practice improvements. However, the study is not without limitations. The sample size may not fully represent the diverse experiences of pharmacists across different healthcare settings and regions, potentially limiting the generalizability of the findings. Furthermore, as the data relied on self-reported responses, there is a risk of response bias, where participants may have provided socially desirable answers rather than fully candid insights. Future research should prioritize a qualitative approach involving both pharmacists and patients, or use a sequential exploratory design that begins with interviews and is followed by survey-based validation, to gain a more comprehensive understanding of disability-related challenges in pharmacy care. In addition, larger-scale studies involving diverse healthcare settings are needed to validate these findings and ensure broader applicability across different contexts.
5. Conclusion
This study highlighted significant physical, communication, and training barriers affecting pharmacy services for individuals with disabilities. The findings emphasized the critical role of training programs, technological solutions, and structural improvements in addressing these barriers. By adopting a multifaceted approach involving policy changes, mandatory staff training, and innovative assistive technologies, pharmacies can become more inclusive and accessible for all patients. Continued collaboration between healthcare stakeholders, policymakers, and technology developers is essential to drive meaningful improvements in pharmacy services for individuals with disabilities.
Ethics Statement
The study underwent review and approval by the IRB committee at Umm Al-Qura University, Makkah, Saudi Arabia (Approval number: HAPO-02-K-012-2024-12-2431). Participation was voluntary, and all data collected were fully anonymized.
Conflicts of Interest
The authors declare no conflicts of interest.
Funding
The authors extend their appreciation to the King Salman Center For Disability Research for funding this work through Research Group no. KSRG-2024-294.
Acknowledgment
The authors extend their appreciation to the King Salman Center For Disability Research for funding this work through Research Group no. KSRG-2024-294.
Open Research
Data Availability Statement
The data that support the findings of this study are openly available in Figshare.com at https://figshare.com/account/items/28352741/edit.
