The Significance of Community Pharmacies' Services Beyond Dispensing Separation: A Rapid Scoping Review

Abstract

Background: The debate on dispensing separation (DS) for community pharmacists in Malaysia has been going on for decades, with numerous arguments arising. Given the evolving role of community pharmacists from medication dispensing to patient care services nowadays, community-based pharmacist practitioners in community-based settings are now capable of developing innovative community pharmacy practices and providing patient care services as a step towards the absence of DS. Objective: The objectives of this rapid scoping review are to provide an overview of the alternative initiatives that can be pursued by community pharmacies beyond DS by incorporating recent reviews and to identify whether these alternative initiatives have benefited patients’ health outcomes in specific diseases, medication management, and quality of life. Method: A systematic literature search was executed on SCOPUS, Web of Science (WOS), and PubMed databases from the time of inception to April 23, 2023, to recognize recent reviews and observational studies related to the alternative initiatives that can be pursued by community pharmacies beyond DS. Inclusion criteria were community pharmacy setting, community pharmacists’ population, full articles published in the English language, and articles published from 2018 to 2023. Results: The review included a total of 19 studies, which consist of 15 review papers, 1 study was a pilot randomised control trial (RCT), and another 3 were observational studies (cross-sectional, cohort, and multicentre descriptive studies). Community pharmacists conducting medication reviews and providing educational counseling were the most common in the 9 included literature searches. These are followed by specialized care services for specific diseases or illnesses being offered by community pharmacists underlined in 9 included studies, such as management of anticoagulation, minor ailments, epilepsy care, chronic pain intervention, obesity and weight services, medicine and alcohol consultation, and other chronic diseases care such as diabetes and hypertension. There were another 3 studies that highlight the expansion of community pharmacists’ services and their responsibilities in preserving continuity of care for society during public health emergencies. Key findings from all 19 studies exhibited a good impact on patient’s adherence to the medication, medication management, significant reduction in DRPs and severity of the diseases, increased detection of ADRs, optimized therapy in chronic diseases, and improved patients’ clinical and health outcomes. Conclusion: Despite the nonexistence of DS policy and its unrealistic implementation within community-based pharmacist practitioners, becoming “indispensable” and evolving to community-based patient care service delivery covering medication optimization, wellness and prevention, chronic and acute care management, and patient education could be successful practice opportunities for community pharmacists.