Journal of Community Health

, Volume 38, Issue 5, pp 812–822 | Cite as

Pharmacists’ Perceived Barriers Providing Non-Dispensing Services to Underserved Populations

  • Lucas Blazejewski
  • Varun Vaidya
  • Sharrel Pinto
  • Caroline Gaither
Original Paper

Abstract

Pharmacists have shown to increase clinical and humanistic outcomes in medically underserved populations through non-dispensing services. Limited information is available regarding the pharmacy workforce’s involvement and ability to serve in this role. The objectives were to measure the proportion of pharmacists working with underserved populations and to assess barriers they encountered when trying to assist. 363 licensed Ohio pharmacists responded to an electronic survey between December 2011 and March 2012 (response rate 19.7 %). The survey assessed personal and environmental barriers that prevent pharmacist involvement with underserved populations using 5-point Likert scales. Multiple logistic regressions identified barriers that influenced pharmacists’ involvement in providing non-dispensing services to underserved populations. 43 % of respondents were assisting underserved populations mostly in their place of work (83 %). Environmental barriers were indicated to effect pharmacists most. Uninvolved pharmacists most agreed with environmental barriers of “Hesitant to volunteer before knowing commitment”, “Never approached to assist”, and “Not enough time during shifts”. Logistic regression 1 incorporated all pharmacists and indicated barriers of “Not interested in this area of work” (OR = 0.589) and “Unsure where to volunteer” (OR = 0.660) as significant. Logistic regression 2 was limited to pharmacists with access to patients at place of work and indicated “Not interested in this area of work” (OR = 0.443), “Employer never approached to assist” (OR = 0.557), “No time during work shifts” (OR = 0.537), and “Work location low underserved accessibility” (OR = 0.487) as significant predictors. More pharmacists might become engaged as volunteers. Increasing communication between community and pharmacists may reduce reported volunteering barriers.

Keywords

Health service accessibility Medication therapy management Pharmaceutical services Pharmacist Vulnerable populations 

References

  1. 1.
    Kaiser Family Foundation. The uninsured: A primer2007 Contract No.: #7451-03.Google Scholar
  2. 2.
    DeNavas-Walt, C., Proctor, B. D., & Smith, J. C. (2010). Income, Poverty, and Health Insurance Coverage in the United States: 2009. Washington, DC: U.S. Census Bureau.Google Scholar
  3. 3.
    Kaiser Commission on Medicaid and the Uninsured. Health insurance coverage of rural America2003.Google Scholar
  4. 4.
    Bodenheimer, T. (2006). Primary care- will it survive? New England Journal of Medicine, 355, 861–864.CrossRefPubMedGoogle Scholar
  5. 5.
    Medicare Payment Advisory Commission (MedPAC). Medicare Payment Policy. Washington, DC: MedPAC2009.Google Scholar
  6. 6.
    Beal, A. C., Doty, M. M., Hernandex, S. E., Shea, K. K., Davis, K. Closing the divide: How medical homes promote equity in health care: Results from The Commonwealth Fund 2006 health care quality survey. New York: The Commonwealth Fund 2007.Google Scholar
  7. 7.
    Cunningham, P. J., & May, J. H. (2006). A growing hole in the safety Net: Physician charity care declines again. Washington, DC: Center for Studying Health System Change.Google Scholar
  8. 8.
    Institute of Medicine. Care without coverage: Too little, too late. Washington, DC2002.Google Scholar
  9. 9.
    Liu, J. (2007). Health profession shortage and health status and health care access. Journal of Health Care for the Poor and Underserved, 18(3), 590–598.CrossRefPubMedGoogle Scholar
  10. 10.
    Casey, M. M., Thiede-Call, K., & Klingner, J. M. (2001). Are rural residents less likely to obtain recommended preventive healthcare services? American Journal of Preventive Medicine, 21(3), 182–188.CrossRefPubMedGoogle Scholar
  11. 11.
    Barton-Burke, M., Smith, E., Frain, J., & Loggins, C. (2010). Advanced cancer in underserved populations. Seminars in Oncology Nursing, 26(3), 157–167.CrossRefPubMedGoogle Scholar
  12. 12.
    Chisholm-Burns, M. A., et al. (2010). US Pharmacists’ Effect as Team Members on Patient Care; Systematic Review and Meta-Analyses. Medical Care, 48(10), 923–933.CrossRefPubMedGoogle Scholar
  13. 13.
    Davidson, M. B., Karlan, V. J., & Hair, T. L. (2000). Effect of a pharmacist-managed diabetes care porgram in a free medical clinic. American Journal of Medical Quality, 15(4), 137–142.CrossRefPubMedGoogle Scholar
  14. 14.
    Hirsch, J. D., Rosenquist, A., Best, B. M., Miller, T. A., & Glimer, T. P. (2009). Evaluation of the first year of a pilot program in community pharmacy: HIV/AIDS medication therapy management for Medi-Cal beneficiaries. Journal of Managed Care Pharmacy, 15(1), 32–41.PubMedGoogle Scholar
  15. 15.
    Taylor, C. T., Byrd, D. C., & Krueger, K. (2003). Improving primary care in rural Alabama with a pharmacy initiative. American Journal of Health-System Pharmacy, 60, 1123–1129.PubMedGoogle Scholar
  16. 16.
    Knight, D. E., Draeger, R. W., Heaton, P. C., & Patel, N. C. (2008). Pharmacist screening for depression among patients with diabetes in an urban primary care setting. Journal of the American Pharmacists Association, 48, 518–521.CrossRefPubMedGoogle Scholar
  17. 17.
    Cohen, L. A., Bonito, A. J., Akin, D. R., et al. (2009). Role of pharmacists in consutling with the underserved regarding toothache pain. Journal of the American Pharmacists Association, 49, 38–42.CrossRefPubMedGoogle Scholar
  18. 18.
    Ndiaye, S. M., Madhavan, S., Washington, M. L., et al. (2003). The use of pharmacy immunization services in rural communities. Public Health, 117, 88–97.CrossRefPubMedGoogle Scholar
  19. 19.
    Caballero, J., Souffrant, G., & Heffernan, E. (2008). Development and outcomes of a psychiatric pharmacy clinic for indigent patients. American Journal of Health-System Pharmacy, 65, 229–233.CrossRefPubMedGoogle Scholar
  20. 20.
    Knapp, K. A., Paavola, F. G., Maine, L. L., Sorofman, B., & Politzer, R. M. (1999). Availability of primary care providers and the pharmacists in the United States. Journal of the American Pharmaceutical Association, 39, 127–135.PubMedGoogle Scholar
  21. 21.
    Wiesner, A. M., Steinke, D. T., Vincent, W. R., Record, K. E., & Smith, K. M. (2010). National survey of pharmacy services in free medical clinics. Journal of the American Pharmacists Association, 50(1), 45–51.CrossRefPubMedGoogle Scholar
  22. 22.
    Dent, L. A., Stratton, T. P., & Cochran, G. A. (2002). Establishing an on-site pharmacy in a community health center to help indigent patients access medications and to improve care. Journal of the American Pharmacists Association, 42, 497–507.CrossRefGoogle Scholar
  23. 23.
    Lansam, G. D., Stone, B. A., Rumsey, T., Shevlin, J. M., Scott, B. E., & Reif, C. J. (1996). Pharmaceutical services for a homeless population. American Journal of Health-System Pharmacy, 53, 1426–1430.Google Scholar
  24. 24.
    Schommer, J. C., Pedersen, C. A., Gaither, C. A., Doucette, W. R., Kreling, D. H., & Mott, D. A. (2006). Pharmacists’ desired and actual times in work activities: Evidence of gaps from the 2004 National Pharmcist WorkForce Study. Jounal of the American Pharmacists Association, 46(3), 340–347.CrossRefGoogle Scholar
  25. 25.
    Barner, J. C., Brown, C. M., Shepard, M. D., Chou, J. Y., & Yang, M. (2002). Provision of pharmacy services in community health centers and migrant health centers. Journal of the American Pharmacists Association, 42(5), 713–722.CrossRefGoogle Scholar
  26. 26.
    Komaromy, M., Lurie, N., & Bindman, A. B. (1995). California physician’s willingness to care for the poor. Western Journal of Medicine, 162, 127–132.PubMedGoogle Scholar
  27. 27.
    Blake, K. B., & Madhavan, S. S. (2010). Perceived barriers to provision of medciation therapy management services (MTMS) and the likelihood of a pharmacist to work in a pharmacy that provies MTMS. Annals of Pharmacotherapy, 44(3), 424–431.CrossRefPubMedGoogle Scholar
  28. 28.
    Alkhateeb, F. M., Unni, E., Latif, D., Shawaqfeh, M. S., & Al-Rousan, R. M. (2009). Physician attitudes toward collaborative agreements with pharmacists and their expectations of community pharmacist responsibilities in West Virginia. Journal of the American Pharmacists Association, 49, 797–800.CrossRefPubMedGoogle Scholar
  29. 29.
    Alkhateeb, F. M., Clauson, K. A., McCafferty, R., & Latif, D. A. (2009). Physician attitudes toward pharmacist provision of medication therapy management services. Pharmacy World and Science, 31, 487–493.CrossRefPubMedGoogle Scholar
  30. 30.
    McGrath, S. H., Synder, M. E., Dueñas, G. G., Pringle, J. L., Smith, R. B., & McGivney, M. S. (2010). Physician perceptions of pharmacist-provided medication therapy management: Qualitative analysis. Journal of the American Pharmacists Association, 50, 67–71.CrossRefPubMedGoogle Scholar
  31. 31.
    Lounsbery, J. L., Green, C. G., Bennett, M. S., & Pdersen, C. A. (2009). Evaluation of pharmacists’ barriers to the implementation of medication therapy management services. Journal of the American Pharmacists Association, 49(1), 51–58.CrossRefPubMedGoogle Scholar
  32. 32.
    Law, A. V., Okamoto, M. P., & Brock, K. (2009). Ready, willing, and able to provide MTM services?: A survey of community pharmacists in the USA. Research in Social Administrative Pharmacy, 5, 376–381.CrossRefPubMedGoogle Scholar
  33. 33.
    Blake, K. B., Madhavan, S. S., Scott, V., & Elswick, B. L. M. (2009). Medication therapy managment services in West Virginia: Pharmacists’ perceptions of education and training needs. Research in Social Administrative Pharmacy, 5, 182–188.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Lucas Blazejewski
    • 1
  • Varun Vaidya
    • 2
  • Sharrel Pinto
    • 2
  • Caroline Gaither
    • 3
  1. 1.Department of Infectious Disease and MicrobiologyUniversity of Pittsburgh Graduate School of Public HealthPittsburghUSA
  2. 2.Department of Health Outcomes and Social SciencesUniversity of Toledo College of Pharmacy and Pharmaceutical SciencesToledoUSA
  3. 3.Department of Pharmaceutical Care and Health SystemsUniversity of Minnesota College of PharmacyMinneapolisUSA

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