A survey to identify barriers in the public health role of community pharmacists

Abstract

Objectives This survey seeks the opinion of UK community pharmacists to identify barriers in the public health role of community pharmacists. Methods This study took the form of a descriptive, cross-sectional survey that generated mostly quantitative data. Questionnaires were mailed to 524 randomly selected community pharmacists from Barnet, London and its surrounding areas, Bedfordshire, Cardiff and Edinburgh. All statistical analyses including tests for significance and correlation of variables were performed using the Statistical Package for the Social Sciences (SPSS version 19.0). Key findings A majority of the respondents identified time pressure and workload (89.7%, C.I. AE4.94); lack of patients' records (78.6%, C.I. AE6.66); insufficient funding from the government (75.2%, C.I. AE7.01); lack of understanding by healthcare providers of the training and skill sets of pharmacists (73.7%, C.I. AE7.25); and lack of understanding by the public of the training and skill sets of pharmacists (72.7%, C.I. AE7.29), as the main barriers in enhancing the public health role of community pharmacists in the UK. Male respondents were more likely to agree that 'insufficient funding' was a barrier (P = 0.006; Eta, g 2 = 0.053). There was a negative correlation between 'age of respondents' and respondents agreeing that pharmacists should develop their own expertise in public health (q = À0.185; P = 0.029). Free text comments also highlighted a number of barriers, which included, among other things, time pressure and workload, commercial pressure from employers, lack of collaboration between healthcare professionals, and inadequate funding. Conclusions Several barriers associated with the public health role of community pharmacists, mainly time pressure and workload; lack of patients' records; insufficient funding from the government; lack of understanding by healthcare providers of the training and skill sets of pharmacists; and lack of understanding by the public of the training and skill sets of pharmacists have been identified as hindering the enhancement of this role. To enable the profession to evolve fully from product-oriented services to patient-centred care, many of these barriers will need to be tackled.

Barriers in the public health role of community pharmacists: a qualitative study

“…As have also been identified in previous studies, inadequate funding for public health services remains a huge challenge for community pharmacy practice. This point was also highlighted by one of the GP participants, when he raised the issue of lack of time for pharmacists,

The pharmacist hasn't got time then.

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“…A UK study identifies that the main roles provided by community pharmacists in public health were in the areas of smoking cessation services; infection control and prevention; promoting cardiovascular health and blood pressure control; provision of emergency hormonal contraception; prevention and management of drug abuse, misuse and addiction; and healthy eating and lifestyle advice. These findings to a large extent confirmed the findings of other UK studies . In a recent white paper, ‘Five year forward view’, the government presented its plan to make greater use of pharmacists through its plan for ‘Multispecialty Community Providers’ (MCPs), which would become the focal point for a far wider range of care needed by their registered patients .…”

Solidarity or dissonance? A systematic review of pharmacist and GP views on community pharmacy services in the UK

“…Despite both pharmacists and GPs acknowledging the importance of collaboration to optimise the provision of extended services, they commonly perceived collaboration to be poor. This perception was influenced by GPs’ negative attitudes towards pharmacists (Agomo, Ogunleye, & Portlock, 2016b; Campion et al., ; Evans et al., ; George et al., 2006b; Latif et al., ; Urban et al., ; Wilcock & Harding, ), GPs being suspicious of pharmacists’ financial motives (Urban et al., ) and competition for services (Agomo et al., 2016b; Evans et al., ; Latif et al., ; Wilcock & Harding, ). Examples of poor engagement included lack of GP availability (Mackridge, Beynon, McVeigh, Whitfield, & Chandler, ; Savage et al., ), patient referrals (Latif et al., ; Lucas & Blenkinsopp, ; Pumtong et al., ) and feedback (Akram et al., ; Urban et al., ).

The only way I think everything could improve would be to have some way of getting the GPs back into the loop and stressing to them how important it is that patients know about any new medications they've been put on… For any service to work you need to have everybody engaged with the actual service and it's just this problem that the lack of responses from GPs.

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“…Lack of publicity for extended services and roles was commonly cited both by pharmacists and GPs. Some pharmacists perceived promotion to be a governmental duty (Agomo et al., 2016b, ; Dewsbury, Rodgers, & Krska, ) with recommendations through public health campaigns and advertising (Agomo et al., 2016b; Horsfield et al., ; Urban et al., ). In one study, pharmacists perceived recommendations by other healthcare professionals, other pharmacists and patients to be the most effective means of raising awareness for medicine‐related services (Gammie, Rodgers, Loo, Corlett, & Krska, ).…”

“…Despite both pharmacists and GPs acknowledging the importance of collaboration to optimise the provision of extended services, they commonly perceived collaboration to be poor. This perception was influenced by GPs' negative attitudes towards pharmacists (Agomo, Ogunleye, & Portlock, 2016b;Campion et al, 2007;Evans et al, 2016;George et al, 2006b;Latif et al, 2016;Urban et al, 2008;Wilcock & Harding, 2008), GPs being suspicious of pharmacists' financial motives (Urban et al, 2008) & Harding, 2008). Examples of poor engagement included lack of GP availability (Mackridge, Beynon, McVeigh, Whitfield, & Chandler, 2010;Savage et al, 2013), patient referrals (Latif et al, 2016;Lucas & Blenkinsopp, 2015;Pumtong et al, 2008) and feedback (Akram et al, 2012;Urban et al, 2008).…”