Extent of pharmaceutical care - based pharmacy practice among community pharmacists in Thai context and It's Influencing factors

Abstract

The objectives of this study were to assess the extent of pharmacy practice among Thai community pharmacist and to determine the factors influencing pharmaceutical care-based pharmacy practice. The focus group was conducted to reveal the actual pharmaceutical care activities in Thai context which consisted of twenty two activities and were grouped into seven domains including patient assessment, therapeutic planning, counseling, medication monitoring, documentation, referral, and health preventive/promotion activities. Barriers for community pharmacists to provide such service were mentioned. The survey instrument was developed based on this focus group results. The conceptual framework of the research was based on the theory of planned behavior, self-efficacy and knowledge-attitude-practice (KAP) model. Of the 1,070 survey questionnaires mailed to Thai community pharmacists, 479 surveys were returned and 40 returned surveys could not be used. The usable response rate was 42.62 percent. Multi-regression analysis was used to determine the factors influencing the intention to provide pharmaceutical care and the current pharmaceutical care practice including the predisposing factors and social cognitive factors, and external factors including barriers toward practice and other environmental and socio-economic factors. Eleven out of twenty four factors were significantly associated with pharmaceutical care-based pharmacy practice with R2 of 0.414 (p<0.05). Eight of the eleven factors including 1) attitude, 2) self efficacy, 3) knowledge, 4) empathy 5) professionalisme, 6) intention, 7) joining in professional organization's project, and 8) influencing of "30 Baht policy", had positive relationship with pharmaceutical care-based pharmacy practice. The remaining others including gender (male), workload, and law enforcement on having pharmacists on duty at pharmacies, had negative relationship. Pharmacists' intention was significantly influenced by seven factors with R2 of 0.509 (p<0.05). Five of the seven factors including 1) attitude, 2) self efficacy, 3) empathy 4) joining in professional organizatin's project, and 5) influencing of "30 Baht policy" had postitive relationship with intention, while gender (male), and workload had negative relationship. The most important factors to explain the intention were attitude and self efficacy (p<0.001). As the result, the provision of pharmaceutical care-based pharmacy practice regarding the explicit activities were addressed among Thai community pharmacists, and significantly internal and external influencing factors toward this extended role were identified.