READINESS AND INTENTION TO PROVIDE EXTENDED COMMUNITY PHARMACY SERVICES

Abstract

Nowadays, roles of the community pharmacists have been changed from drug dispensing by expanding to focus more on patients-oriented service. The new extended services were implemented in several developed countries. This study aimed to investigate physicians’, consumers’ and community pharmacists’ attitude toward the proposed extended community pharmacy services and to evaluate factors influencing community pharmacists’ intention to deliver these new extended community pharmacy services. For the first phase study, a qualitative approach involving an in-depth interview was conducted in three informant groups; consumers, physicians and community pharmacists in Bangkok metropolitan area. The interviews investigated informants’ knowledge about and opinions toward ten extended pharmacy services provided in community pharmacy. For the second phase study, a cross-sectional study using self-administered mail survey was conducted in Bangkok area. Community pharmacists; owners or managers, were requested to complete questionnaire. Factors affecting intention to provide two priorities extended services derived for first phase study, medicine management program ad disease screening, were evaluated. Results from the first phase study revealed that consumers were less acquainted with extended patient-oriented services while physicians were the most knowledgeable group. Six main themes were identified; access to service, perceived benefits and barriers, system readiness, service quality assurance, pharmacy readiness and scope of professional responsibility. Medicines management was 100% agreed by all informants that it should be provided in community pharmacy. Return of unwanted medicine, smoking cessation, promotion of healthy lifestyle and weight management were also highly agreed to be provided in community pharmacy. Disease screening was agreed by pharmacists and consumers, but some physicians disagreed. Results from the second phase study revealed that most community pharmacists intention to provide disease screening (27.60%) and medication management program (24.10%) within one year. As for factor which significantly affected on community pharmacists’ intention to provide these services based on diffusion of innovation theory, only compatibility with pharmacy profession framework had statistically significant effect on intention to provide medication management program (OR=2.995, 95% CI=1.034-8.671). Complexity had statistically significant effect on intention to provide disease screening (OR=0.328, 95% CI=0.111-0.968). In conclusion, medicine management program and disease screening should be provided in Thai community pharmacy as priority. However, capacity building to prepare system readiness was identified a crucial success factor. Compatibility with pharmacy profession framework was the most important characteristic of medication management program while complexity was the most important characteristic of disease screening. NHSO and policy maker should develop business model and strategy based on findings from these study results for sustainable community pharmacy profession.