Aim To explore community pharmacists' role in educating and advising cancer patients and their carers on optimum use of opioids for pain relief.

Methods Semi-structured interviews with a maximum diversity sample of 25 community pharmacists in three areas of England.

Results Pharmacists had no reliable method to identify a patient with cancer, had few face to face contacts with patients and no means of accessing relevant medical information. Patients' medicines were often collected by carers or delivered to their homes, and reliable access to palliative care medicines remains problematic. Pharmacists reported that a wide range of issues are raised with them by carers but these rarely included questions about opioid medicines. For some pharmacists, proactive involvement appeared to be inhibited by fear of discussing emotional and wider social aspects. Many pharmacists assumed information had already been provided by another clinician and felt isolated from other members of the care team. Medicines Use Reviews for cancer patients regarding their analgesia were rarely undertaken.

Conclusions Community pharmacists felt that their potential contribution to cancer pain management is constrained but they aspired to do more. Since they generally did not know which patients have cancer their provision of information and advice was ad hoc. There was little evidence of routine communication about patient care in relation to analgesia either from or to pharmacists. People with cancer and their families may currently have less access to information and support from community pharmacists than people with other conditions.