Skip to main content

Advertisement

Log in

Turkish community pharmacists’ behavioral determinants in provision of pharmaceutical care to elderly patients

  • Research Article
  • Published:
International Journal of Clinical Pharmacy Aims and scope Submit manuscript

Abstract

Background It is crucial to develop and implement community pharmacist-led pharmaceutical care services in primary care that could prevent and detect potentially inappropriate prescribing and promote medication adherence in older patients. Objective The aim of this study was to determine community pharmacists’ perceived barriers and facilitators face during the provision of pharmaceutical care to older patients by using a theoretical domains framework. Method A cross-sectional online survey was conducted among community pharmacists in Turkey. A Turkish version of the 50-item Determinants of Implementation Behavior Questionnaire was developed to evaluate behavioral determinants of community pharmacists on delivering pharmaceutical care to older patients. Main outcome measures The behavioral determinants of community pharmacists. Results A total of 354 community pharmacists answered the questionnaire. The mean age was 43.2 (standard deviation = 11.1), and 227 (64%) of the pharmacists were female. Community pharmacists' positive opinions on pharmaceutical care service outcomes in older patients and feedback were regarded as facilitators. Community pharmacists' motivational level and emotions were additional determinant facilitators in delivering pharmaceutical care to older patients. Their negative opinions on the impact and action of pharmaceutical care in older patients were regarded as barriers. Conclusion In primary health care, a theory-based e-distant training program for community pharmacists and the guidelines for standard pharmaceutical care services led by community pharmacists could be designed by addressing barriers related to the impact and action of pharmaceutical care in older patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Luetsch K. Attitudes and attributes of pharmacists in relation to practice change: a scoping review and discussion. Res Soc Adm Pharm. 2017;13(3):440–55.

    Article  Google Scholar 

  2. Tommelein E, Mehuys E, Petrovic M, Somers A, Colin P, Boussery K. Potentially inappropriate prescribing in community-dwelling older people across Europe: a systematic literature review. Eur J Clin Pharmacol. 2015;71(12):1415–27.

    Article  Google Scholar 

  3. Nothelle SK, Sharma R, Oakes A, Jackson M, Segal JB. Factors associated with potentially inappropriate medication use in community-dwelling older adults in the United States: a systematic review. Int J Pharm Pract. 2019;27(5):408–23.

    Article  Google Scholar 

  4. Rankin A, Cadogan CA, Patterson SM, Kerse N, Cardwell CR, Bradley MC, et al. Interventions to improve the appropriate use of polypharmacy for older people. Cochrane Database Syst Rev. 2018;2018(9):CD008165.

    PubMed Central  Google Scholar 

  5. Patwardhan PD, Amin ME, Chewning BA. Intervention research to enhance community pharmacists’ cognitive services: a systematic review. Res Soc Adm Pharm. 2014;10(3):475–93.

    Article  Google Scholar 

  6. Stewart D, Klein S. The use of theory in research. Int J Clin Pharm. 2016;38(3):615–9.

    Article  CAS  Google Scholar 

  7. Cassie H, Duncan EM, Gibb EA, Power A, Young L, Newlands R, et al. Qualitative study exploring the key determinants of information gathering to inform the management of over-the-counter (OTC) consultations in community pharmacies. BMJ Open. 2019;9(8):12.

    Article  Google Scholar 

  8. Willis SC, Seston EM, Family H, White S, Cutts C. Extending the scope of community pharmacists’ practice to patients requiring urgent care: an evaluation of a training programme using the theoretical domains framework. Health Soc Care Community. 2019;27(4):999–1010.

    Article  Google Scholar 

  9. Paudyal V, Smith KG, MacLure K, Forbes-McKay K, Radley A, Stewart D. Perceived roles and barriers in caring for the people who are homeless: a survey of UK community pharmacists. Int J Clin Pharm. 2019;41(1):215–27.

    Article  Google Scholar 

  10. Hansen CR, Byrne S, O’Mahony D, Kearney PM, Sahm LJ. Qualitative analysis of community pharmacists’ opinions on their involvement in reducing potentially inappropriate prescribing. Eur J Clin Pharmacol. 2019;75(2):265–74.

    Article  Google Scholar 

  11. Cardwell K, Hughes CM, Ryan C. Community pharmacists’ views of using a screening tool to structure medicines use reviews for older people: findings from qualitative interviews. Int J Clin Pharm. 2018;40(5):1086–95.

    Article  Google Scholar 

  12. Murphy AL, Phelan H, Haslam S, Martin-Misener R, Kutcher SP, Gardner DM. Community pharmacists’ experiences in mental illness and addictions care: a qualitative study. Subst Abuse Treat Prev Policy. 2016;11:14.

    Article  Google Scholar 

  13. Michie S, Johnston M, Abraham C, Lawton R, Parker D, Walker A, et al. Making psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care. 2005;14(1):26–33.

    Article  CAS  Google Scholar 

  14. Cane J, Richardson M, Johnston M, Ladha R, Michie S. From lists of behaviour change techniques (BCT s) to structured hierarchies: comparison of two methods of developing a hierarchy of BCTs. Br J Health Psychol. 2015;20(1):130–50.

    Article  Google Scholar 

  15. Michie S, Richardson M, Johnston M, Abraham C, Francis J, Hardeman W, et al. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann Behav Med. 2013;46(1):81–95.

    Article  Google Scholar 

  16. Huijg JM, Gebhardt WA, Dusseldorp E, Verheijden MW, van der Zouwe N, Middelkoop BJC, et al. Measuring determinants of implementation behavior: psychometric properties of a questionnaire based on the theoretical domains framework. Implement Sci. 2014;9:15.

    Article  Google Scholar 

  17. Stewart D, Cunningham S, Strath A, MacLure A, Gibson-Smith K, Rushworth GF, et al. A theoretically informed survey of the views and experiences of practicing pharmacists on research conduct, dissemination and translation. Res Soc Adm Pharm. 2019;15(11):1298–308.

    Article  Google Scholar 

  18. Stewart D, Thomas B, MacLure K, Wilbur K, Wilby K, Pallivalapila A, et al. Exploring facilitators and barriers to medication error reporting among healthcare professionals in Qatar using the theoretical domains framework: a mixed-methods approach. PLoS ONE. 2018;13(10):19.

    Google Scholar 

  19. Al Shemeili S, Klein S, Strath A, Fares S, Stewart D. An exploration of health professionals’ experiences of medicines management in elderly, hospitalised patients in Abu Dhabi. Int J Clin Pharm. 2016;38(1):107–18.

    Article  Google Scholar 

  20. Rushworth GF, Cunningham S, Pfleger S, Hall J, Stewart D. A cross-sectional survey of the access of older people in the Scottish Highlands to general medical practices, community pharmacies and prescription medicines. Res Soc Adm Pharm. 2018;14(1):76–85.

    Article  Google Scholar 

  21. Cadogan CA, Ryan C, Francis JJ, Gormley GJ, Passmore P, Kerse N, et al. Improving appropriate polypharmacy for older people in primary care: selecting components of an evidence-based intervention to target prescribing and dispensing. Implement Sci. 2015;10:14.

    Article  Google Scholar 

  22. Seward K, Wolfenden L, Wiggers J, Finch M, Wyse R, Oldmeadow C, et al. Measuring implementation behaviour of menu guidelines in the childcare setting: confirmatory factor analysis of a theoretical domains framework questionnaire (TDFQ). Int J Behav Nutr Phys Act. 2017;14(1):45.

    Article  Google Scholar 

  23. WHO. Process of translation and adaptation of instruments 2016 https://www.who.int/substance_abuse/research_tools/translation/en/. Accessed 12 November 2020.

  24. Ustun G, Soylemez SL, Ucar N, Sancar M, Okuyan B. Assessment of the pharmacy students’ e-health literacy and mobile health application utilization. J Res Pharm. 2020;24(1):23–9.

    Google Scholar 

  25. Alqubaisi M, Tonna A, Strath A, Stewart D. Quantifying behavioural determinants relating to health professional reporting of medication errors: a cross-sectional survey using the Theoretical Domains Framework. Eur J Clin Pharmacol. 2016;72(11):1401–11.

    Article  Google Scholar 

  26. Osborne JW, Costello AB, Kellow JT. Best practices in exploratory factor analysis. Best practices in quantitative methods. 2008; 86–99. https://methods.sagepub.com/base/download/BookChapter/best-practices-in-quantitative-methods/d8.xml. Accessed 12 November 2020.

  27. Grady A, Seward K, Finch M, Fielding A, Stacey F, Jones J, et al. Barriers and enablers to implementation of dietary guidelines in early childhood education centers in Australia: application of the theoretical domains framework. J Nutr Educ Behav. 2018;50(3):229-37.e1.

    Article  Google Scholar 

  28. Arnold H, Wallace SJ, Ryan B, Finch E, Shrubsole K. Current practice and barriers and facilitators to outcome measurement in aphasia rehabilitation: a cross-sectional study using the theoretical domains framework. Aphasiology. 2020;34(1):47–69.

    Article  Google Scholar 

  29. Benrimoj SI, Langford JH, Berry G, Collins D, Lauchlan R, Stewart K, et al. Economic impact of increased clinical intervention rates in community pharmacy: a randomised trial of the effect of education and a professional allowance. Pharmacoeconomics. 2000;18(5):459–68.

    Article  CAS  Google Scholar 

  30. Blake KB, Madhavan SS, Scott V, Elswick BLM. Medication therapy management services in West Virginia: pharmacists’ perceptions of educational and training needs. Res Soc Adm Pharm. 2009;5(2):182–8.

    Article  Google Scholar 

  31. Law AV, Okamoto MP, Brock K. Ready, willing, and able to provide MTM services? A survey of community pharmacists in the USA. Res Soc Adm Pharm. 2009;5(4):376–81.

    Article  Google Scholar 

  32. Dunlop JA, Shaw JP. Community pharmacists’ perspectives on pharmaceutical care implementation in New Zealand. Pharm World Sci. 2002;24(6):224–30.

    Article  Google Scholar 

  33. Roberts AS, Benrimoj SI, Chen TF, Williams KA, Aslani P. Implementing cognitive services in community pharmacy: a review of models and frameworks for change. Int J Pharm Pract. 2006;14(2):105–13.

    Article  Google Scholar 

  34. Roberts AS, Benrimoj SI, Chen TF, Williams KA, Aslani P. Practice change in community pharmacy: quantification of facilitators. Ann Pharmacother. 2008;42(6):861–8.

    Article  Google Scholar 

  35. Chui MA, Mott DA, Maxwell L. A qualitative assessment of a community pharmacy cognitive pharmaceutical services program, using a work system approach. Res Soc Adm Pharm. 2012;8(3):206–16.

    Article  Google Scholar 

  36. Doucette WR, Nevins JC, Gaither C, Kreling DH, Mott DA, Pedersen CA, et al. Organizational factors influencing pharmacy practice change. Res Soc Adm Pharm. 2012;8(4):274–84.

    Article  Google Scholar 

  37. Bryant LJM, Coster G, Gamble GD, McCormick RN. General practitioners’ and pharmacists’ perceptions of the role of community pharmacists in delivering clinical services. Res Soc Adm Pharm. 2009;5(4):347–62.

    Article  Google Scholar 

  38. Tarn DM, Paterniti DA, Wenger NS, Williams BR, Chewning BA. Older patient, physician and pharmacist perspectives about community pharmacists’ roles. Int J Pharm Pract. 2012;20(5):285–93.

    Article  Google Scholar 

  39. Sancar M, Okuyan B, Apikoglu-Rabus S, Izzettin F. Opinion and knowledge towards pharmaceutical care of the pharmacists participated in clinical pharmacy and pharmaceutical care continuing education program. Turk J Pharm Sci. 2013;10(2):245–54.

    Google Scholar 

  40. Silva BB, Fegadolli C. Implementation of pharmaceutical care for older adults in the brazilian public health system: a case study and realistic evaluation. BMC Health Serv Res. 2020;20(1):1–14.

    Article  Google Scholar 

  41. Michie S, van Stralen MM, West R. The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implement Sci. 2011;6:11.

    Article  Google Scholar 

  42. Patton DE, Ryan C, Hughes CM. Enhancing community pharmacists’ provision of medication adherence support to older adults: a mixed methods study using the theoretical domains framework. Res Social Adm Pharm. 2020;S1551–7411(20):30032–42.

    Google Scholar 

Download references

Acknowledgements

We like to thank Prof Derek Stewart for his advice and encourage for developing theory based pharmaceutical services and all community pharmacists who participated this study.

Funding

Funding

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Betul Okuyan.

Ethics declarations

Conflicts of interest

None.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Okuyan, B., Balta, E., Ozcan, V. et al. Turkish community pharmacists’ behavioral determinants in provision of pharmaceutical care to elderly patients. Int J Clin Pharm 43, 1024–1035 (2021). https://doi.org/10.1007/s11096-020-01211-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-020-01211-0

Keywords

Navigation