Barriers to Compliance with OBRA'90 Regulations in Community Pharmacies

Abstract

Community pharmacists in Massachusetts are making an attempt to comply with OBRA'90, but there are specific barriers that are affecting their ability to do so. The OBRA'90 regulations appear to have had little impact on the practice of most community pharmacies. Community pharmacy management needs to examine (1) expanded roles of supportive personnel to give pharmacists more time to spend counseling patients, (2) reimbursement mechanisms for cognitive service, and (3) approaches to educating patients about these changes in the pharmacy profession.

How do Australian metropolitan and rural pharmacists counsel consumers with prescriptions?

“…In line with previous studies [24,26], the two cohorts more frequently counselled consumers collecting new prescriptions than those collecting regular prescriptions. In terms of providing verbal information, a significantly higher proportion of metropolitan than rural pharmacists reported verbally counselling on more than 50% of prescriptions dispensed.…”

“…Although some significant differences were revealed, overall, the two cohorts tended to demonstrate a similar pattern in their counselling behaviour. Similar to findings based on self-reports [24][25][26], the vast majority of metropolitan and rural pharmacists in this study reported that they delivered verbal information as well as initiated discussion with consumers about prescription medicines. While over 70% of metropolitan and rural pharmacists usually provided information in semiprivate areas, only a few counselled in a private area.…”

Implementing cognitive services in community pharmacy: a review of facilitators used in practice change

“…43,44 While it may be one part of an overall approach towards increasing CPS delivery, there are still other barriers to be overcome, as some experiences with USA legislation would attest. [45][46][47] Furthermore, Almarsdóttir et al argue that the fundamental changes in focus that are required for pharmacists to provide CPS are not something that can be imposed upon them. 43 The authors suggest that changes must come from within the profession of community pharmacy itself.…”

Awareness of and Readiness for Medication Therapy Management Among Community Pharmacists in New York City: Results from a Focus Group

“…These challenges are commonly cited in the literature when it comes to providing MTM and cognitive services. 20,[29][30][31][32] Reimbursement has been a contentious issue for many years, and much of the discussion from our focus group was centered on this issue. Ideas for reimbursement included: receiving varied fees based on different levels of service similar to what physicians currently use; reimbursement based on current costs of a pharmacist (a set fee per minute of MTM); and a tiered system with specific fees for different components of MTM.…”