A national survey of pharmacists and interns in Aotearoa New Zealand: provision and views of extended services in community pharmacies

Abstract

Background Changes in pharmacy models of care, services and funding have been occurring internationally, moving away from the traditional dispensing role to more extended patient-facing roles utilising pharmacists’ clinical skills. This study aimed to identify the extended services offered by community pharmacy in Aotearoa New Zealand and the barriers and facilitators to extended services provision. The study is unique in that it includes intern (pre-registration) pharmacists. Methods An online survey, conducted in 2018, of all pharmacists and intern (pre-registration) pharmacists working in a community pharmacy. Data were analysed using descriptive statistics and regression analyses. Results The results are based on replies from 553 community pharmacists and 59 intern pharmacists (response rate: 19 and 26% respectively). Both pharmacists (83%) and interns (85%) want to work at the top of their scope of practice. Wide variation exists in the specific services individual pharmacists offer. Most pharmacists were accredited to supply the emergency contraceptive pill (95%), sildenafil for erectile dysfunction (86%) and trimethoprim for uncomplicated urinary tract infection (85%). Fewer were able to immunise (34%) or to supply selected oral contraceptives (44%). Just under a quarter could provide a Medicines Use Review (MUR) or Community Pharmacy Anticoagulation Management Service (CPAMS). Of the pharmacists not already accredited, 85% intended to gain accreditation to supply selected oral contraceptives, 40% to become vaccinators, 37% to offer CPAMS and 30% MUR. Interns expressed strong interest in becoming accredited for all extended services. Poisson regression analyses showed key factors supporting the likelihood of providing extended services were owner and management support and appropriate space and equipment. Being excited about the opportunities in community pharmacy, having employer funding and time for training and sufficient support staff were also statistically significant. Conclusions Pharmacists need time and a supportive management structure to enable them to deliver extended services. Health policy with a greater strategic emphasis on funding services and pharmacist training, and developing technician support roles, will help to minimise or eliminate some of the barriers to role expansion both in Aotearoa New Zealand and internationally.

Knee osteoarthritis and the knowledgeable, trustworthy pharmacist: Patient and pharmacist perceptions of community pharmacy‐based education and support

“…Pharmacists felt well placed to fulfil a care coordination and ongoing support role, given their existing patient relationships, and welcomed the opportunities for better recognition of their skill set and interdisciplinary collaboration. Pharmacist enthusiasm for providing extended pharmacy services is consistent with findings from recent survey of NZ pharmacists (McDonald et al., 2021). Similar to McDonald et al.’s survey, pharmacists in our study highlighted the importance of additional training and sufficient funding to support their ability to provide effective and sustainable extended services.…”

Use of pharmacy services in community-dwelling middle-aged and older adults; findings from The Irish Longitudinal Study on Ageing (TILDA)

“…A total of 96.6% of participants (5,587) reported visiting a pharmacy in the previous 12 months, and almost one fifth of these (1,094, 18.9%) availed of at least one specified pharmacy service. 16.23287349 doi: medRxiv preprint 8 using any services, service users were a similar age (mean 68 years), but were taking more medications (mean 3.6 versus 2.8), were more often female (64.1% versus 54.2%), had higher educational attainment, and had higher GP visit rates. Considering the relationship between specific high-risk medications and requesting advice about medications, there was a statistically significant associations for anticoagulant, antiplatelet, and NSAID medication use (Figure 2).…”

“…; https://doi.org/10.1101/2023.03. 16.23287349 doi: medRxiv preprint Introduction Community pharmacy has a potentially significant role in expanding access to community-based healthcare while providing enhanced services outside of traditional medication dispensing. In recent years, the role of community pharmacists has evolved globally, with expansion in a wide variety of pharmacy services offered in the community setting,(1) with further developments since the onset of the COVID-19 pandemic.…”

“…The copyright holder for this preprint this version posted March 17, 2023. ; https://doi.org/10.1101/2023.03. 16.23287349 doi: medRxiv preprint income threshold, entitling to free GP visits), or neither of these. TILDA participants are asked to report doctor-diagnosed health conditions (based on a list of common conditions, and with the opportunity to provide "other" responses) and medications they take on a regular basis.…”

“…The copyright holder for this preprint this version posted March 17, 2023. ; https://doi.org/10.1101/2023.03. 16.23287349 doi: medRxiv preprint…”