Community pharmacists’ routine provision of drug-related problem-reduction services

Abstract

Objectives The present study aimed to assess the degree of the provision of services for drug-related problems (DRPs) and the factors affecting provision within the community pharmacy setting in Irbid, a large city in Northern Jordan. Methods A cross-sectional survey was developed and administered to community pharmacists in Irbid, Jordan during the period from January to May 2017. The survey is composed of background and practice characteristics, services provided routinely by the community pharmacists to address DRPs, and barriers and facilitators for DRP-reduction services. A summated score quantifying the degree of DRP-reduction service provision was calculated, which included overall scores and scores for the different scales and domains. Statistical analysis included descriptive statistics and a multivariate linear regression model for factors associated with the high provision of DRP-reduction service. Results Two hundred community pharmacists out of 210 pharmacists approached completed the surveys yielding a response rate of 95.2%. The most frequent DRPs encountered within the routine practice in the community pharmacy were economic aspects (76.0%). The mean total score relating to different DRP-reduction services was 32.9 (58.8%) out of 56 as the maximum possible score. It was estimated that 28.2% of the responding pharmacists provided the service overall (scored more than 50% of the scale). For the assessment, intervention, and referral dimensions, similar percentages of providers of the services were achieved: 59.7%, 61.9%, and 49.0%, respectively. Lower rates of providers were achieved on the documentation scale (12.9%). The lack of recognition of the pharmacist role by physicians was the most commonly reported barrier to effective DRP-reduction services among community pharmacists (78.9%). The ability to receive external guidance was indicated by the majority of surveyed pharmacists (94.5%) as a potential facilitator to DRP-reduction services in this study. Predictors associated with high total scores were the presence of medical records for the patients in the pharmacy, patients contact the pharmacy using email, a high satisfaction in professional relationships with physicians, and pharmacists’ age. Conclusion Even though community pharmacists in this study have been shown to deliver certain activities to address DRPs to a high degree, the overall rate of DRPs services was suboptimal. Community pharmacists reported several barriers that should be taken into consideration to facilitate the role of community pharmacists in providing adequate DRP reduction services to patients.

Costs saved and avoided from pharmacist interventions to address drug-related problems identified from outpatient clinics in Jordan

“…DRPs in Jordan are more likely to occur in an outpatient setting as opposed to a hospital setting due to the high rates of DRPs in the outpatient setting [ 15 ] and the limited provision of intervention to address DRPs by community pharmacists [ 16 ]. This emphasizes the necessity of research output informing the value and importance of pharmacist input to enhance the management of outpatient medications.…”

Patterns of drug-related problems and the services provided to optimize drug therapy in the community pharmacy setting

“…The most common barriers to the provision of DRP-reduction services in the present study were increased workload (60.5%), limited time (53.2%), and lack of good communication skills (49.8%). More than half of the pharmacists surveyed in a previous Jordanian study believed that limited time and high workload were barriers to the provision of DRP-reduction services ( Al-Taani and Ayoub, 2022 ). Similarly, lack of time and work force was also identified as the most significant barrier preventing the practice of pharmaceutical care in another study ( Victory Evans et al, 2021 ).…”

“…After review of the related literature ( Al-Taani and Ayoub, 2022 , Hughes et al, 2010 ), the current self-administered, online-based survey was developed. A group of experts including two academic professors of clinical pharmacy, a professor of public health and two clinical pharmacists evaluated the questionnaire for face and content validity.…”

“…These efforts aimed to improve the overall quality of care and ensure that patients receive comprehensive support from their community pharmacies. Several variables including the availability of patients' medical records in the pharmacy, patients contacting the pharmacy via email, a high level of satisfaction in working relationships with physicians, and the age of the pharmacists, can affect the provision of these services ( Al-Taani and Ayoub, 2022 ). Previous research has identified a broad range of barriers to the provision of DRP-reduction services such as lack of laws and guidelines, unacceptance of the pharmacist role, lack of time and training, increased workload, and poor relationship between the community pharmacists with other healthcare providers ( Al-Taani and Ayoub, 2022 , Inamdar et al, 2018 , Palaian et al, 2022 , Usman and Ilyas, 2014 , Victory Evans et al, 2021 ).…”

“…Several variables including the availability of patients' medical records in the pharmacy, patients contacting the pharmacy via email, a high level of satisfaction in working relationships with physicians, and the age of the pharmacists, can affect the provision of these services ( Al-Taani and Ayoub, 2022 ). Previous research has identified a broad range of barriers to the provision of DRP-reduction services such as lack of laws and guidelines, unacceptance of the pharmacist role, lack of time and training, increased workload, and poor relationship between the community pharmacists with other healthcare providers ( Al-Taani and Ayoub, 2022 , Inamdar et al, 2018 , Palaian et al, 2022 , Usman and Ilyas, 2014 , Victory Evans et al, 2021 ). Moreover, the perceptions and expectations of the public regarding the role of community pharmacists in UAE are influenced by various factors such as the healthcare authorities, level of knowledge demonstrated by the pharmacists, their attire, nationality, age, and the location of the pharmacy ( Rayes et al, 2014 ).…”