Community pharmacists in Khartoum State, Sudan: Their current roles and perspectives on pharmaceutical care implementation

Department of Pharmacy and Pharmacology, University of Bath, Claverton Down, Bath, BA2 7AY, UK, .
International journal of clinical pharmacy 12/2012; 35(2). DOI: 10.1007/s11096-012-9736-x
Source: PubMed


Background The contribution of community pharmacists to the provision of primary healthcare is widely believed to be important. The health authority in Sudan is interested in developing pharmaceutical care (PC) practice as a means of improving the provision of primary healthcare services. However, there is a need for research to inform this development. Objectives To describe the current roles of community pharmacists; to describe their views about their current role and potential future role with regard to PC practice. Settings Community pharmacies in Khartoum State, Sudan. Methods This study applied a two-phase mixed methods approach. The first phase used a pre-tested, piloted, self-administered questionnaire with a stratified random sample of 246 pharmacies (26 % of total number) in Khartoum State. The sample size was based on 95 % confidence level, 5 % confidence interval and the response rate from the pilot study. The second phase applied semi-structured interviews with a purposive sample of 24 of the responded pharmacists. Main outcome measure Current activities of community pharmacists; pharmacists' opinions on PC practice and the barriers they might face in its implementation. Results For the questionnaire study the response rate was 83 % (205/246). Most dispensing activities were reported to be performed by a vast majority of respondents (94 % or more). A few PC activities were reported to be already performed by the majority of participants e.g. checking indications, interactions and contraindication (83 %, n = 171) and checking each repeat prescription for compliance (78 %, n = 159). However, the majority of PC activities were not performed. Nearly all pharmacist (99 %, n = 203) were willing to further implement PC practice, but reported a number of barriers to its implementation. Conclusion Efficient dispensing of prescriptions is the primary focus of community pharmacists in Khartoum State with some PC activities. The pharmacists have expressed a willingness to implement PC practice but indicated a number of barriers to successful implementation.

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    • "What is more, in the case of an insufficient number of employees, pharmacists are compelled to carry out non-specific administration duties, not related to work with patients, which could be fulfilled by persons without pharmaceutical education (Waszyk-Nowaczyk and Simon, 2009). Similar problems have also been noted in other countries (Hughes et al., 2010; Perraudin et al., 2011; Van den Brink et al., 2012; Ibrahim and Scott, 2013). A pharmacist is the first person addressed by a patient with a health problem due to often an impossible immediate contact with a physician within the service of the National Health Fund in Poland (Jasin´ska and Orszulak-Michalak, 2009). "
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    ABSTRACT: Implementation of pharmaceutical care (PC) in Poland is of great importance to patients, who, on the one hand, often follow complex pharmacological treatment regimens recommended by several physicians of different specialties, and, on the other one, take up the decision on self-treatment due to availability of OTC medications. The aim of the present study was to assess the opinion of both patients and physicians about implementation of PC service in Polish community pharmacies. A cross sectional study was carried out from September 2009 to September 2010 by a pharmacist (author of the study) on the basis of an anonymous questionnaire, where demand of physicians (n=104) and patients (n=202) for implementation of PC in a community pharmacy was assessed. The study was planned to determine the relationship between implementation of PC, cost and time of this service and patients’ and physicians’ socio-economic information. Responding patients (85.64%) and physicians (76.92%) unanimously confirmed the need for implementation of PC. Most people convinced of the service implementation were 88.89% of physicians under the age of 35 and all the respondents over 65 years of age (p=0.027), just as 93.33% with service shorter than 5 years and 73.68% of respondents working a maximum of 20 years (p=0.023). Mainly according to 90.00% of physicians with specialty in internal medicine and 92.59% of physicians of the group “Others” (p=0.012), PC should be implemented in pharmacies. Women more frequently than men reckoned that appointments with a pharmacist should last up to 15 minutes (p=0.012). According to 77.78% of the youngest physicians and 83.33% of the oldest ones, appointments should last from 5 to 15 minutes (p=0.049), and similar opinion was shared by 80.77% of physicians without specialty and 77.78% of physicians of the group “Others” (p=0.0009). According to patients, mean cost of the visit should be USD 7. Physicians the most often assessed mean cost of the appointment at USD 14 . This study provides new data about implementation of PC in Poland. The increased patients’ and physicians’ willingness to benefit from this service provides pharmacists with opportunities to develop PC in community pharmacies.
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    ABSTRACT: Background: Pharmacists are well placed to identify, prevent and resolve medicine related problems as well as monitor the effectiveness of treatments in cardiovascular disease (CVD). Pharmacists' interventions in CVD secondary prevention have been shown to improve outcomes for clients with established CVD. Objective: To explore the scope of pharmacists' activities in supporting CVD secondary prevention. Setting: Community pharmacies in New South Wales, Australia. Methods: Twenty-one in-depth, semi-structured interviews with a range of community pharmacists were conducted. All interviews were audio-recorded and transcribed ad verbatim. Data were analyzed using a 'grounded-theory' approach by applying methods of constant comparison. Main outcome measure: Community pharmacists' awareness and current practice in supporting secondary prevention of CVD. Results: Four key themes identified included 'awareness', 'patient counselling', 'patient monitoring', and 'perceptions of the role of pharmacists in CVD secondary prevention'. The pharmacists demonstrated a moderate understanding of CVD secondary prevention. There was considerable variability in the scope of practice among the participants, ranging from counselling only about medicines to providing continuity of care. A minority of pharmacists who had negative beliefs about their roles in CVD secondary prevention offered limited support to their clients. The majority of pharmacists, however, believed that they have an important role to play in supporting clients with established CVD. Conclusion: Community pharmacists in Australia make a contribution to the care of clients with established CVD despite the gap in their knowledge and understanding of CVD secondary prevention. The scope of practice in CVD secondary prevention ranged from only counselling about medicines to offering continuity of care. The extent of pharmacists' involvement in offering disease management appears to be influenced by their beliefs regarding what is required within their scope of practice.
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    ABSTRACT: Objectives To describe the current and potential roles of Sudanese community pharmacists in responding to symptoms (RTS) and chronic diseases management (CDM) and identify perceived barriers. Settings Community pharmacies in Khartoum State. Method A structured, self-administered, piloted questionnaire was conducted of pharmacists in charge of 274, randomly selected, community pharmacies. Close ended questions and a 5-point Likert-type scale were used to measure responses. Main outcome measure Respondents' demographics, their current activities, attitude and involvement in RTS and CDM and potential barriers. Response rate was 67 %. The majority of respondents (>90 %) reported that they are involved in RTS activities but have negative views regarding practice standards. They lack specific lists of minor conditions and their treatment (87.4 %), recorded counseling procedure (84.7 %), and referral forms (85.8 %). Almost all community pharmacists see an important role for them in CDM (4.54 ± 0.74, 95.3 %) and accept team work with other health care providers (4.46 ± 0.74, 87.5 %). Lack of proper knowledge and training, time, space, patients' acceptance and official recognition of pharmacists' new role, were some of the identified barriers. Conclusion Sudanese community pharmacists provide RTS and CDM services; however, clinical knowledge and training and well defined national practice standards needs were identified. The current product-focused activities need to be refined to include more patient-focused services. For Improved patients' self-care services, a number of obstacles identified by surveyed pharmacists need to resolved. This requires collaboration of different parties including academics, governmental bodies and professional organizations.
    No preview · Article · Jan 2014
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