Extemporaneous Dispensing: Opinions of Victorian Community Pharmacists

Abstract

Objectives: To determine estimates ofthe type and extent of extemporaneous dispensing undertaken by Victorian community pharmacists and to analyse their views on related issues. Study Procedure: After telephone contact, a survey was mailed to every third community pharmacy in Victoria (n = 420). Results: Completed surveys were received from 296 premises (70.5%). 1. Sample: 71% male; 61% sole/partner proprietor; 35% PhC and 67% BPharm graduates. 2. Extent: 60% dispensed 1-5 extemporaneous prescriptions per week (excluding water reconstitutions); for 7 5% of the sample, extemporaneous prescriptions made up <I% of total prescriptions. 3. Preparation: 63% rated the adequacy of the range of ingredients as high or very high, 52% and 10% stated that the prescriber was often or very often a dermatologist and general practitioner, respectively. 4. Demand for service: 72% felt that extemporaneous prescribing had decreased or greatly decreased in the past five years, and 74% felt it would decrease or greatly decrease in the future. 5. Pharmacist confidence and satisfaction: 68% had high or very high confidence in their extemporaneous dispensing ability and 60% had high or very high satisfaction. 6. Factors influencing attitudes: high or very high on the list were time constraints for 3 5%; lack of stability data for 20%; and unknown efficacy for 20%. 7. Proposals for future: 75% agreed or strongly agreed that extemporaneous dispensing should remain one of the tasks undertaken by all pharmacists, 3% agreed or strongly agreed to forgo for all, and 13% agreed or strongly agreed to specialisation. 8. Skill/eve! (since registration): 45% felt it was at the same level. 9. Need for refresher course: 21% felt it would be useful or very useful for them. Conclusions: Even though extemporaneous dispensing forms a minor part of community pharmacy business, most pharmacists strongly believed it should be retained by the profession generally. Main concerns revolved around time constraints for undertaking the task and lack of stability and clinical efficacy information. Most pharmacists reported that their levels of skill and preparation were of a high order. However, there were some areas for improvement, particularly relating to raw materials handling and equipment maintenance. It is recommended that comprehensive self-audits and update courses are implemented for quality assurance of dispensed products. Aust J Hosp Pharm

Community pharmacy compounding–impact on professional status

“…McPherson et al (2010) found that physicians frequently consulted the compounding pharmacist about aspects of formulation, pharmaceutical presentation and compounded options as part of a collaborative prescribing process [52]. A high level of interest in and support for pharmacy compounding was also reported by in a survey of general practitioners in Australia [53]. Again, although limited by regional sampling and potential non-response bias, a study on the attitudes of medical specialists in Atlanta (USA), had similar results in that prescribers had a positive attitude towards compounding and the compounding pharmacist's ability and knowledge to participate in prescribing decisions [54].…”

Extemporaneous Prescribing: Whatever Happened to It? A Survey of Australian General Practitioners

“…A 1999 Australian study, 3 and an unpublished 2000 study conducted by Smith et al 4 in New Zealand (using the same survey instrument) have confirmed that the dispensing of such products has declined over the years. It was found that these products only represent one to two per cent of community pharmacies' total prescription volume.…”

“…The transition from the use of botanical to synthetic products, and the development of proprietary medicines, resulted in the decline of production of extemporaneous products/ although they continue to be available (albeit in smaller numbers) on the Pharmaceutical Benefits Scheme (PBS). A 1999 Australian study, 3 and an unpublished 2000 study conducted by Smith et al 4 in New Zealand (using the same survey instrument) have confirmed that the dispensing of such products has declined over the years. It was found that these products only represent one to two per cent of community pharmacies' total prescription volume.…”

Specialised Compounding—Practices and Opinions of Australian Community Pharmacists

“…These findings are in agreement with Pappas, and a recently published survey of the prevalence of compounding in the US. 15,16 The responses to questions about demographic factors such as gender, qualifications, PhARIA class, prescription volume, turnover, pharmacy size, staffing levels and Quality Care Pharmacy Program accreditation were similar to those reported by Dunphy et al, Berbatis et al and the Pharmacy Guild of Australia and indicate that the sample was representative of pharmacies in Australia. 13,14,17 One of the limitations of this study was that a self-reported survey instrument was used and the reliability of responses was not able to be independently checked.…”

“…15 Our survey found that the majority of pharmacies dispensed less that 1% of prescriptions extemporaneously but that almost all pharmacies prepared extemporaneous products. These findings are in agreement with Pappas, and a recently published survey of the prevalence of compounding in the US.…”