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      Current Perceptions and Improvement Approaches of Pharmaceutical Care Capacity of Community Pharmacists: A Quantitative Analysis Based on Survey Data at Chinese Chain Pharmacies

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          Abstract

          Background: The benefits of patient-focused pharmaceutical care in improving clinical outcomes and reducing health expenditure have been well documented. However, these services are not fully implemented in many developing countries like China, especially in the community setting at chain pharmacies. Methods: A cross-sectional questionnaire-based survey was conducted at nine chain pharmacies in eight provinces of China in late 2019 to assess the difference in attitude, perceived barriers, and expected facilitators of Chinese community pharmacists to deliver pharmaceutical care, as well as their willingness to develop the competencies based on age, education level, and seniority. A quantitative analysis of responses was undertaken by using nonparametric (Kruskal–Wallis) and chi-square tests (followed by Bonferroni post-hoc test). Results: A total of 1260 community pharmacists were enrolled in the survey. In total, 16.3% of participant pharmacists often felt that lack of ability had a negative impact on work especially when providing comprehensive medication guidance (39.0%); 44.4% were unsatisfied with academic degrees; 85.8% were “very willing” to improve ability of pharmaceutical care while only 46.9% and 38.4% regarded traditional practice and continuing education as of lots of help, respectively. Main barriers in capacity enhancement were linked to conflict with daily work (35.4%), conflict with family life (21.9%), and poor memories (15.3%). The most welcomed facilitators to enhance pharmaceutical care development included professional skills training (28.4%), self-study of online resources (20.3%), and adult education in universities (15.6%). Community pharmacists of different age, education level, and seniority held significantly different opinions on the above aspects ( p < 0.05). Conclusion: Chinese community pharmacists showed a positive attitude towards capacity enhancement in pharmaceutical care. Specific efforts and reforms should be made to improve the professionalism and to remove barriers based on their age, different education level, and seniority.

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          Opportunities and responsibilities in pharmaceutical care

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            Role of the pharmacist in reducing healthcare costs: current insights

            Global healthcare expenditure is escalating at an unsustainable rate. Money spent on medicines and managing medication-related problems continues to grow. The high prevalence of medication errors and inappropriate prescribing is a major issue within healthcare systems, and can often contribute to adverse drug events, many of which are preventable. As a result, there is a huge opportunity for pharmacists to have a significant impact on reducing healthcare costs, as they have the expertise to detect, resolve, and prevent medication errors and medication-related problems. The development of clinical pharmacy practice in recent decades has resulted in an increased number of pharmacists working in clinically advanced roles worldwide. Pharmacist-provided services and clinical interventions have been shown to reduce the risk of potential adverse drug events and improve patient outcomes, and the majority of published studies show that these pharmacist activities are cost-effective or have a good cost:benefit ratio. This review demonstrates that pharmacists can contribute to substantial healthcare savings across a variety of settings. However, there is a paucity of evidence in the literature highlighting the specific aspects of pharmacists’ work which are the most effective and cost-effective. Future high-quality economic evaluations with robust methodologies and study design are required to investigate what pharmacist services have significant clinical benefits to patients and substantiate the greatest cost savings for healthcare budgets.
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              From "retailers" to health care providers: Transforming the role of community pharmacists in chronic disease management.

              Community pharmacists are the third largest healthcare professional group in the world after physicians and nurses. Despite their considerable training, community pharmacists are the only health professionals who are not primarily rewarded for delivering health care and hence are under-utilized as public health professionals. An emerging consensus among academics, professional organizations, and policymakers is that community pharmacists, who work outside of hospital settings, should adopt an expanded role in order to contribute to the safe, effective, and efficient use of drugs-particularly when caring for people with multiple chronic conditions. Community pharmacists could help to improve health by reducing drug-related adverse events and promoting better medication adherence, which in turn may help in reducing unnecessary provider visits, hospitalizations, and readmissions while strengthening integrated primary care delivery across the health system. This paper reviews recent strategies to expand the role of community pharmacists in Australia, Canada, England, the Netherlands, Scotland, and the United States. The developments achieved or under way in these countries carry lessons for policymakers world-wide, where progress thus far in expanding the role of community pharmacists has been more limited. Future policies should focus on effectively integrating community pharmacists into primary care; developing a shared vision for different levels of pharmacist services; and devising new incentive mechanisms for improving quality and outcomes.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                14 October 2020
                October 2020
                : 17
                : 20
                : 7482
                Affiliations
                Department of Clinical Pharmacy and Pharmaceutical Affairs, School of Pharmacy, Fudan University, Shanghai 201203, China; zjtang@ 123456fudan.edu.cn (Z.T.); 16301030101@ 123456fudan.edu.cn (P.L.); yehua@ 123456fudan.edu.cn (H.Y.); honglan@ 123456fudan.edu.cn (L.H.)
                Author notes
                [* ]Correspondence: xiangxq@ 123456fudan.edu.cn ; Tel.: +86-21-5198-0024
                Author information
                https://orcid.org/0000-0001-8260-0082
                https://orcid.org/0000-0002-8683-2603
                Article
                ijerph-17-07482
                10.3390/ijerph17207482
                7602434
                33066654
                243080f1-ee81-45f0-88db-02a5dc923952
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 31 August 2020
                : 10 October 2020
                Categories
                Article

                Public health
                china,community pharmacist,chain pharmacy,pharmaceutical care,capacity enhancement
                Public health
                china, community pharmacist, chain pharmacy, pharmaceutical care, capacity enhancement

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