Mix-Methodological Assessment Of Extended Community Pharmacy Services: Perspectives Of Community Pharmacists And Policy Makers In Lahore, Pakistan
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Date
2017-08
Authors
Hashmi, Furqan Khurshid
Journal Title
Journal ISSN
Volume Title
Publisher
Universiti Sains Malaysia
Abstract
In recent decades, community pharmacies reported a change of business model, whereby a shift from traditional services to the provision of extended roles was observed. However, such delivery of extended pharmacy services (EPS) is reported from the developed world, and there is scarcity of information from the developing nations. Within this context, the present study was aimed to explore knowledge, perception, and attitude of community pharmacists (CPs) and policy makers (PMs) about EPS and their readiness and acceptance for practice change in the city of Lahore, Pakistan. The present study was conducted using mix-methodological approach in which, qualitative and quantitative methodologies were employed to explore the perception of CPs and PMs about the practice change, preparedness and EPS in Lahore, Pakistan. A triangulation of qualitative and quantitative studies was used and the thesis includes two qualitative studies conducted in CPs and PMs followed by a questionnaire-based cross-sectional quantitative study involving CPs in Lahore, Pakistan. For the two qualitative studies, 12 CPs and 7 PMs were interviewed face-to-face respectively. The interviews werecarried out in English language, audio-recoded and transcribed verbatim. Thematic content analysis (TCA), of first study involving CPs, yielded themes such as; familiarity with EPS, current practice of EPS, training needed to provide EPS, acceptance or preparedness for EPS and barriers towards the provision of EPS in Lahore. While, the study on PMs in Lahore, the TCA resulted in themes such as; current standard of community pharmacy practice, current knowledge about EPS, practice change and readiness of CPs towards practice change and barriers towards practice change in Lahore. Based on the findings of the qualitative studies, questionnaire-based cross-sectional quantitative study in CPs working in pharmacies in Lahore was designed. The survey was conducted in CPs (n = 384) in Lahore, to explore the perception, knowledge attitude towards practice change as well as to find out their preparedness for the practice change and provision of EPS. Facilitators and barriers toward the provision of EPS were also evaluated. The response rate was calculated to be 63.02% (n = 242). Majority of respondents were male CPs, 82.2% (n = 199) while only 17.8% (n = 43) female CPs with mean age of 27.58±4.55 and mean experience 3.04 ± 3.36 years and majority, 84.3% were employed licensed pharmacists working in urban localities of Lahore. The association between the respondents’ demographic variables and barriers to the practice change, provision of extended pharmacy services (EPS), facilitators to EPS, preparedness of CPs for EPS and the perception about the regulatory officers was calculated using the Mann Whitney U and Kruskal Wallis tests. Shortage of pharmacists, lack of appropriate knowledge and skills by pharmacists, lack of opportunity and impairment of relationship with local GPs; and inspection of community pharmacy by regulatory officer—a time-consuming process, were found to be significant (P<0.05) barriers toward the provision of EPS in Lahore. The facilitators as accreditation of specific service such as home medication review (HMR) were also significant (P<0.05). it was perceived significant (P<0.05) that CPs had enough knowledge and skills to provide extended services as an evidence of preparedness towards EPS in Lahore. In conclusion, this mix-methodology study investigated the perspective of CPs and PMs in Lahore, about the current community pharmacy practices, facilitators to transformation of change and preparedness of CPs towards change in practice. The current barriers toward provision of EPS were identified. Development of evidence-based policies, legislation and amendment in existing laws is necessary by involving all stakeholders such as CPs, PMs, government agencies and other healthcare professionals.
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Keywords
Mix-methodological assessment of , extended community pharmacy services