Family Practice Vol. 18, No. 5, 534-536
© Oxford University Press 2001
Health Services Research |
Attitudes of the general public to the expanding role of community pharmacists: a pilot study
Department of General Practice and Primary Care and
a Department of Public Health, University of Aberdeen and
b Old Machar Medical Practice, Aberdeen, UK.
Lisa Iversen, University of Aberdeen, Department of General Practice and Primary Care, Foresterhill Health Centre, Westburn Road, Aberdeen AB25 2AY, UK.
Iversen L, Mollison J and MacLeod TNN. Attitudes of the general public to the expanding role of community pharmacists: a pilot study. Family Practice 2001; 18: 534–536.
Received 18 October 2000; Revised 21 February 2001; Accepted 4 May 2001.
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Abstract |
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Background. The extension of the role of the community pharmacist in the UK has been under discussion for several years. Professional opinions have been reported. It is important to investigate consumer attitudes towards the acceptability of the proposed new role of the pharmacist.
Objectives. This pilot study investigated the attitudes of consumers to the proposed extended role of the community pharmacist.
Methods. A total of 173 printed questionnaires were mailed to a random sample of patients stratified by age and sex, registered with an urban general practice in the north east of Scotland. The questionnaire asked subjects their views on ideas for new services to be provided by community pharmacists.
Results. A total of 96 questionnaires were returned (response rate 55%). Respondents were in favour of community pharmacist involvement in non-medicine-related roles such as ‘healthy living’ advice but less in favour of roles where the pharmacist would have access to selected information from medical records.
Conclusion. This pilot study has indicated a range of attitudes towards the extended role of the community pharmacist. It is important to investigate fully consumer attitudes towards the acceptability of the new role of the pharmacist.
Keywords. Attitudes, community pharmacist, consumers.
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Introduction |
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In 1995, the Royal Pharmaceutical Society of Great Britain (RPSGB) began a consultation exercise to develop a strategy for pharmacy in the 21st century—Pharmacy in a New Age.1 It was emphasized that consumers are often unaware of the services that pharmacists offer. Key areas where the role of pharmacists could be expanded were: management of prescribed medicines; management of long-term conditions and common ailments; promotion and support of healthy lifestyles; and advice and support for other health professionals.1 For GPs, the extended role of the community pharmacist may lead to a reduction in workload with initiatives such as (the pharmacist working with patients in) medication reviews.2 This pilot study aimed to investigate attitudes of consumers to the proposed extended role of the community pharmacist.
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Methods |
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Subjects were identified from one urban general practice in Grampian. A random sample stratified by age and sex was selected from the computerizd patient register (n = 200). The study planned to sample 150 subjects, to ensure the estimates were within 10% of the population parameters, allowing for 30% non-response. After exclusions by the GP, due to patient medical problems or involvement in other research, 173 subjects remained. Questionnaires were sent to all 173 subjects.
Subjects received a self-completion postal questionnaire designed following Pharmacy in a New Age1 and other relevant literature,3,4 with a personalized covering letter from the GP (TNNM). The questionnaire investigated whether the general public (and thus potential consumers of pharmacy services) endorsed new ideas for particular services to be provided by community pharmacists. Closed questions (with options ‘yes’, ‘no’ or ‘don’t know’) and open comments sections were used.
One reminder was sent to non-responders 14 days after the initial mailing. Data analysis was carried out using SPSS for Windows 8. Characteristics of responders and non-responders were compared using an independent t-test for continuous variables and a chi-squared test for categorical variables. McNemar's test was used to compare responder attitudes to de-regulation of emergency contraception and the oral contraceptive pill.
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Results |
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A response rate of 96/173 (55%) was obtained after two mailings. The mean age of the respondents was 42 years (range 18–70 years), and 39 (41%) were male. Responders were more likely to be female (59% versus 41%, P<0.01) and older (mean age: 42 versus 37 years, P<0.01) than non-responders.
Table 1
summarizes attitudes to the expanding role of community pharmacists. Respondents were particularly in favour of community pharmacists providing support for other health professionals 74 (77%), for healthy living sessions 71 (74%) and for health screening to be provided by pharmacists 68 (71%). Subjects were less supportive of pharmacist involvement in monitoring long-term illness such as asthma 21 (22%), providing antibiotics for minor respiratory infections 37 (39%) or providing the contraceptive pill without a prescription 34 (35%). Fewer than half of respondents were in favour of pharmacist access to patient medical records 34 (35%).
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Discussion |
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The limitations of this study are acknowledged; the response rate of 55% and the location of the study practice mean that we cannot be confident that the attitudes expressed reflect the sample or the UK population. However, this pilot survey has illustrated an interesting range of attitudes towards various aspects of the pharmacists' extended role as defined by Pharmacy in a New Age.1
Although pharmacists would describe themselves as experts on medicines, this survey indicates greater support from the public for non-medicine-related roles such as ‘healthy living’ advice. This is counter to the findings of much of the research in this area.3 More respondents (68%) were in favour of a repeat dispensing system where the patient does not have to visit the GP for repeats of long-term medication.
More respondents were in favour of de-regulation of emergency contraception than of the contraceptive pill (P = 0.06). De-regulation of emergency contraception was supported by 43 (45%) of respondents, which is similar to findings concerning the provision of emergency contraception5 and is important given the recent de-regulation of the progesterone-only treatment.6
This pilot study suggests that consumers of pharmacy services may not be entirely supportive of the expanding role of the community pharmacist. Reasons for this may include lack of understanding of pharmacists' expertise and concerns regarding access to medical records.4 The questionnaire did not explore all possible new roles and perhaps respondents would have supported other roles such as management of common ailments (which does not necessarily involve the supply of antibiotics).
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Conclusion |
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Further work considering consumers' attitudes, their knowledge of pharmacists' capabilities and training, and the promotion of community pharmacy services is required. Extending the role of the community pharmacist will only be effective if new roles are what consumers want and find acceptable. For pharmacists to become fully involved in the primary health care team, positive endorsement and recommendation of their role by professional colleagues to the public may be a key factor.2
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Acknowledgments |
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We would like to thank the patients who took part in the survey, and Professor CM Bond and Dr NC Campbell for help and encouragement in the drafting process. This study was carried out as a final year undergraduate student project.
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References |
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1 Royal Pharmaceutical Society of Great Britain. Pharmacy in a New Age: Building the Future. London: Royal Pharmaceutical Society of Great Britain, 1997.
2 Sodha M, Dhillon S, Rajyaguru R, Shah R, Watman G. Evaluation of the role and effectiveness of pharmacists working with general practitioners. Pharm J 1999; 263: R39.
3 Jepson M, Jesson J, Kendall H, Pocock R. Consumer Expectations of Community Pharmaceutical Services: A Research Report for the Department of Health. London: Department of Health, 1991.
4 Vallis J, Wyke S, Cunningham-Burley S. Users' views and expectations of community pharmacists in a Scottish commuter town. Pharm J 1997; 258: 457–460.
5 Matheson CI, Smith BH, Flett G et al. Over-the-counter emergency contraception: a feasible option. Fam Pract1998; 15: 38–43.
6 Levonelle launched. Pharm J 2001; 266: 136–139.
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