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Perspectives of community pharmacists in Pakistan about practice change and implementation of extended pharmacy services: a mixed method study

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Abstract

Background Community pharmacists’ role in the primary health care, patient-centered services, beyond traditional dispensing services is well established in the developed world. However, this role is not fully established in low-middle-income countries including Pakistan. Objective To explore community pharmacists’ perspectives and preparedness about practice change and associated facilitators and barriers to extended services. Setting A study was conducted involving community pharmacists of Lahore, Pakistan. Method Two phased studies were conducted using mixed-method sequential design. The first phase involved qualitative semi-structured face-to-face interviews with the community pharmacists, while the second phase constituted a questionnaire-based cross-sectional study. Main outcome measure Pharmacists’ perspectives about extended pharmacy services, facilitators, barriers and preparedness for the practice change. Results For the first phase, pharmacists were purposively sampled and the saturation yielded a final sample size of fifteen pharmacists (N = 15). The thematic content analysis yielded four distinct themes; (1) current practices and familiarity with extended pharmacy services (2) practice gap between Pakistan and the developed countries (3) facilitators and the preparedness, and (4) barriers towards its implementation and provision. The second part was a questionnaire-based cross-sectional phase, where a total of 348 community pharmacists were approached, while only 242 responded, yielding a response rate of 69.5%. The triangulation of qualitative and quantitative data identified several barriers such as; shortage of pharmacists, lack of knowledge and skills, poor collaboration with general practitioners, failure of customers to pay for extended services. Facilitators and preparedness for the provision of extended pharmacy services were; access to patient notes, follow-up, separate counselling areas, accreditation of specific services and sufficient resources. Conclusion This study’s findings call for the implementation and enforcement of Punjab Drug Sale Rules 2007 to facilitate the practice change and provision of comprehensive pharmacy services in Punjab, Pakistan. There is a need for additional laws to define community pharmacists’ roles, uniform job description, training, new funding model, separate area, and accreditation of extended pharmacy services in Pakistan.

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Acknowledgements

We acknowledge the participation of community pharmacists to responding the current research work. The facilitation by the Primary and Secondary Health Care Department, Government of the Punjab has been appreciable throughout the period of research and we extend our gratitude to Dr. Munawar Hayat, Chief Drug Controller of the Government of the Punjab, Lahore, for his support. We extend our gratitude and are thankful to Ms Zineb Riboua, McCourt School of Public Policy, Georgetown University, Washington D.C., USA for professional editing and final proof reading of the manuscript.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Conflicts of interest

The authors declare no competing interests.

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Authors and Affiliations

  1. University College of Pharmacy, University of the Punjab Allama Iqbal Campus, Lahore, Pakistan

    Furqan Hashmi, Hamid Saeed & Muhammad Islam

  2. Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Minden, Pulau Penang, Malaysia

    Mohamed Azmi Hassali

  3. Faculty of Pharmacy, University of Balochistan, Sariab Road, Quetta, Pakistan

    Fahad Saleem

  4. School of Pharmacy, Xi’an Jiaotong University, Xi’an, China

    Usman Rashid Malik & Naveel Atif

  5. Department of Pharmacy, University of Huddersfield, Huddersfield, HD1 3DH, UK

    Zaheer-Ud-Din Babar

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  1. Furqan Hashmi
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Contributions

FH: Conceptualization, methodology, formal analysis, investigation, data curation, and writing—original draft preparation. MAH: Resources, validation, investigation, project administration. FS: Data curation, formal analysis. HS: Visualization, writing—reviewing and editing. MI: Formal analysis, investigation. UM: Investigation, writing—reviewing and editing. NA: Data curation, investigation, writing—reviewing and editing. ZUDB: Supervision, validation, writing—reviewing and editing.

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Correspondence to Furqan Hashmi.

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Hashmi, F., Hassali, M.A., Saleem, F. et al. Perspectives of community pharmacists in Pakistan about practice change and implementation of extended pharmacy services: a mixed method study. Int J Clin Pharm 43, 1090–1100 (2021). https://doi.org/10.1007/s11096-020-01221-y

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