Professional Services Offered By Community Pharmacists And Challenges In Managing Community Pharmacies: Views From Community Pharmacy Practitioners In The State Of Sarawak

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Date
2018-08
Authors
Kho, Boon Phiaw
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Universiti Sains Malaysia
Abstract
The focus of community pharmacies worldwide is gradually shifting towards service-based. Unfortunately, various management challenges delay this progression, especially in developing countries like Malaysia. Dimension of challenges faced in the management of community pharmacies is poorly articulated in the literature. The aims of this study were to explore the current status of professional pharmacy services provision and management challenges faced by community pharmacists in Sarawak, Malaysia. A mixed-methods design comprising qualitative (Phase 1) and quantitative (Phase 2) components was used. In Phase 1, semi-structured interviews were carried out with community pharmacists practising in Sarawak. Purposive and snowball sampling techniques were employed to ensure a diverse group of informants, with data saturation achieved after 20 interview sessions. Interviews were audio-recorded and transcribed verbatim, with the resultant data analysed using thematic analysis. Eleven major themes were identified. Professional pharmacy service provision was influenced by both respondents’ intrinsic motivations and business considerations. Intra-organisational constraints faced include lack of time, personnel and physical space, whereas cultural issues, uncommitted customers, stock availability and price issues were the extra-organisational barriers. Market demand influenced respondents’ plans for further service expansion. Management challenges experienced traverse five domains: market competition, legislative issues, customers’ knowledge and expectations, macroeconomic impacts and operational problems. Improving customer service quality and expanding the range of professional services were suggested coping strategies. In Phase 2, survey questionnaires constructed using Phase 1 findings and supplemented with relevant literature were posted to all eligible community pharmacies in Sarawak (n=184). A total of 80 responses were received (response rate 43.5%). High levels of response homogeneity were recorded for various economic, operational and customer-related challenges faced. Strategic changes to counter these challenges were focused on pricing and product stocked, rather than service provision. Most rated strategies include increasing discounts for customers and sourcing cheaper suppliers. Legislative change proposals that can increase their share of the pharmaceutical market were strongly supported by respondents, particularly those that address pricing issues and the lack of dispensing separation. In conclusion, current legislative conditions and Malaysian consumer mindset might have constrained professional services provision and strategic choices of community pharmacies to deal with contemporary management challenges faced. A long-term multi-pronged approach to address these issues and increased involvement of community pharmacists themselves in this agenda are required to influence practice change.
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Medicine
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