Community pharmacists’ understanding, attitudes, practice and perceived barriers related to providing pharmaceutical care: a questionnaire-based survey in Macao

Purpose: To explore the knowledge, attitudes, practice and perceived barriers of community pharmacists regarding provision of pharmaceutical care as well as provide recommendations on how to advance the service during the early stage of development in Macao. Methods: A questionnaire comprising 10 items was used to collect respondents’ demographic information and to evaluate their understanding of pharmaceutical care, attitude towards service provision, current practice and perceived barriers. Descriptive and comparative analysis of the results was conducted. Results: While 95 % of the participating pharmacists agreed that patients’ health was their primary responsibility, only 57 % believed that they can provide better pharmaceutical care in the future. The majority spent most of their work time counselling patients (90 %) and checking prescription (70 %). Only a small portion monitored adverse drug reaction and drug compliance (44 %), engaged in health screening or drug safety promotion (20 %) or maintained patient medication records (4 %). Insufficient communication with physicians (90 %), lack of time (79 %) and lack of physical space at the pharmacy (76 %) were considered the most significant barriers. Conclusion: A suboptimal level of pharmaceutical care is provided by pharmacists in Macao. Considering the barriers identified and integrating other country experiences, establishing an enabling atmosphere using policy and regulatory measures is the fundamental element for advancing pharmaceutical care by community pharmacists.

Influence of pharmacists expertise on physicians prescription decisions

Purpose: To explore the influence of pharmacist factors on prescription decisions of physicians. Methods: A survey of literature was carried out across online databases and 12 relevant articles were identified. The influence of pharmacist factors on physician prescription decisions was identified in the articles. A conceptual model for investigating pharmacist factors that influence physicians’ prescription decisions was then developed. Results: The main factors identified were pharmacist expertise, pharmacist – physician collaboration, and trust between physician and pharmacist. There was no direct evidence of influence of pharmacist expertise on prescription, but some studies indicated that pharmacist recommendation is in tandem with the prescribing behaviour of physicians. One study reported that pharmacist–physician collaboration positively influenced physicians’ prescribing decision, while others found no relationship between these. Conclusion: Existing literature on the influence of pharmacist factors on prescription behaviour of physicians are limited and debatable. There is no consistency in these studies. Moreover, studies that reported a strong connection between the trustworthiness and pharmacist–physician collaboration in drug prescription lack hard evidence.