Pharmacists as accessible primary health care providers: Review of the evidence

Abstract

Primary health care is defined as a patient's first point of contact with the health care system. As such, pharmacists are an integral part of primary health care. Indeed, for many years, we have said that pharmacists see their patients more frequently than they see any other health care practitioner, including physicians. Let's review the evidence for that. To address this topic, we searched PubMed/MEDLINE, Scopus, EMBASE, Cochrane Library, Web of Science and CINAHL Plus from their inception to October 2017. The searches combined relevant keywords and subject headings relating to the concept of pharmacist visit frequency. The search terms used included pharmacist, pharmacy, visit, visit frequency, follow up frequency, physician, doctor and general practitioner. An additional search was conducted in Google for the phrase "pharmacists see patients more than physicians. " The results of these searches are shown in Table 1. Using Saskatchewan population data, Shiu et al. 2 demonstrated that pharmacists see patients with diabetes at least twice as frequently as general practitioners and 36% more than any physician. 2 These results did not change when stratified by the size of the urban centres. 2 McNamara et al. 1 reported that patients in rural Australia visit their general practitioners more frequently than they visit their pharmacists. However, when broken down by age groups, this finding appears to be driven by patients who are younger than 65 years of age (25-64 years, with over half of those being under 55 years). It is very plausible that younger patients might not have as many chronic conditions as older patients, and so they might visit their general practitioner more frequently (presumably for acute conditions). When looking at patients aged 65 years and older (65-84 years; 40% of patients), the visits to community pharmacists were more frequent. Jose et al. 3 did not include a comparator group but interestingly reported visit frequency numbers similar to those reported by Shiu et al. 2 and the older * No data or citation provided.

Opportunistic screening for type 2 diabetes in community pharmacies. Results from a region-wide experience in Italy

“…Public pharmacies, being very accessible, are frequently a contact point with the health care system [8]. In Italy there are more than 19000 community pharmacies, 1500 in Piedmont.…”

Together we unite: the role of the Commonwealth in achieving universal health coverage through pharmaceutical care amidst the COVID-19 pandemic

“…Pharmacists are skilled worldwide to provide more extensive public-facing servicessuch as family planning, HIV testing, screening, and vaccination. These extended pharmacy servicesparticularly vaccination serviceswill be key for achieving population vaccination coverage when a COVID-19 vaccine becomes available, especially as pharmacies are one of the most accessible health providers in the community [54]. The effectiveness of utilising pharmacists for public health interventions has been highlighted through Commonwealth initiatives led by female pharmacist groups to set-up clinical breast screening and raise awareness to reach the most vulnerable communities.…”

The impact of community pharmacist involvement on transitions of care: A systematic review and meta-analysis

“…Community pharmacists (i.e., pharmacists who practice in community settings whose primary role involves dispensing) are recognized as one of the most accessible health care professionals. 8 Their role has evolved over time to take on more clinical activities, such as immunizations, health screenings, and medication therapy reviews, and are increasingly being looked to by health care stakeholders to improve medication-related metrics among populations. 9 Furthermore, community pharmacists often develop longlasting therapeutic relationships with their patients, and they have shown increased potential to address many population health issues, such as medication-related issues during transitions in care.…”