Pharmacists' perceptions regarding their contribution to improving the public's health: a systematic review of the United Kingdom and international literature 1990–2001

Abstract

Objective To systematically review, summarise and evaluate the published evidence from 1990–2001 relating to pharmacists' attitudes towards and perceptions of their role in improving the public's health. Methods Electronic databases searched were MEDLINE, EMBASE, Cochrane Library and International Pharmaceutical Abstracts. Hand searches were undertaken of a number of relevant journals and conference abstracts. Studies on pharmacy and health education, health promotion, public health, smoking cessation, diet, body weight, and coronary heart disease were identified. All relevant studies with an English language abstract were included. Two of the authors separately examined the lists of titles and abstracts of papers from the searches and then compared inclusion/ exclusion lists and resolved any differences by discussion. Two approaches were used to assess the quality of the evidence and each study was allocated an evidence grade. Data were abstracted into a matrix and a narrative report constructed to synthesise the evidence. Key findings The search identified 12 studies (nine from the UK and three from other countries), all of which involved community pharmacists. Pharmacists attach a high degree of importance to health improvement activities. They are more comfortable with activities that are related to medicines and need support to extend their range of health‐related work. Pharmacists' advice is more likely to be reactive than proactive; their concerns about being “intrusive” in offering potentially unwelcome health advice predisposes to a reactive stance. While dispensing duties were widely reported by pharmacists as a key barrier to greater involvement in activities that improve the public's health, the review of the evidence showed that perceptions and attitudes are also key to pharmacists' behaviour in relation to these activities. Conclusion Community pharmacists' activities in improving the public's health centre around medicines. This is unsurprising, as dispensing and sale of medicines constitute a pharmacist's core business, and are the areas that they are perceived to be expert in and in which they have received the most training. If pharmacists are to contribute to wider public health activities, ways need to be found of extending their sphere of activity. The review findings have implications for those involved in education and training of pharmacists at undergraduate and postgraduate levels.

Social Capital and Community Pharmacy

“…Furthermore, this short critical review has highlighted very few studies (qualitative or quantitative) that have moved beyond identifying what pharmacists already do routinely (e.g., health promotion, health education, smoking cessation etc.) (see for example Anderson et al 2003). Basic descriptive and evaluative research, exploring how the pharmacy might already contribute to the development of social capital and community development is required, coupled with case studies of good practice in local areas (Ghalamkari and Jenkins 2002).…”

“…As Anderson et al (2003) argue in a recent review of pharmacists' views about their contribution to public health, pharmacists still centrally identify themselves as experts in medicines. There remain significant attitudinal and structural barriers to them developing a sustained and publicly acknowledged role in the provision of health promotion and a reactive approach to this still prevails within the profession .…”

“…Whilst many of the new roles for pharmacists involve the sale or supply of medicines by different means (for example, via patient group directions or pharmacist prescribing) and are mainly aimed at improving access to medicines, other suggested developments shift community pharmacy practice into rather more unfamiliar territory. In particular, there is now increasing interest in the role that pharmacists might play in public health, and the term 'pharmaceutical public health' is increasingly heard within practice research circles and pharmacy policy more generally, both in the UK and abroad (Boorman et al 2001;Anderson et al 2003;Jones et al 2004). For example, the Department of Health in England has devoted considerable attention to the idea of pharmaceutical public health.…”

A Public Health Pharmacy Course at a Malaysian Pharmacy School

“…[9][10][11][12] A review of the published evidence from 1990-2001 relating to pharmacists' attitudes and perceptions towards their role in improving public health showed that they were more comfortable with activities related to medicines and needed additional training to extend their range of health-care activities. 13 The findings of this review have important implications for educators and trainers of pharmacists at undergraduate and postgraduate levels. 13 In most developed nations of the world, many pharmacy schools have integrated public health pharmacy courses as one of the core subjects to be taught in their undergraduate curriculums.…”

“…13 The findings of this review have important implications for educators and trainers of pharmacists at undergraduate and postgraduate levels. 13 In most developed nations of the world, many pharmacy schools have integrated public health pharmacy courses as one of the core subjects to be taught in their undergraduate curriculums. 14,15 In Malaysia, improving public health is firmly on the national healthcare agenda and the government's health policy offers an unparalleled opportunity for pharmacists to be recognized as part of the public health workforce.…”