Pharmacists’ attitudes and perceived barriers to provision of adherence support in Australia
- 607 Downloads
Background Adherence to therapy is a key to achieving good clinical outcomes. Promoting medication adherence requires a range of strategies that primarily focus on fostering behavioral change. Community pharmacists are well placed to deliver adherence support to patients. Aim To investigate community pharmacists’ activities in supporting patient medication adherence in their practice; and to assess pharmacists’ attitudes and barriers to adherence support. Method A sample of 500 pharmacies was randomly selected from a list of community pharmacies in the state of New South Wales (Australia) and mailed a questionnaire focusing on provision of adherence support, pharmacists’ attitudes, and barriers to adherence support. Two follow-up reminders were sent to non-responding pharmacies after 2 and 6 weeks. Result A response rate of 27.6 % was achieved (n = 126), consistent with recent research studies. For less than half (42 %) of prescriptions dispensed, pharmacists reported providing strategies to identify non-adherent patients. Providing dose administration aids was the most common method to support adherence used by pharmacists (95 %). Most (98 %) agreed that it was their role to promote patients’ adherence. However 64 and 52 % reported that patients’ time pressures and poor health literacy, respectively, were the main barriers to provision of adherence support. Around 25 % of respondents reported that they had received training programs on providing medication adherence support. Conclusion Community pharmacists employed a limited range of strategies to identify and address non-adherence to medications. Moreover, the provision of adherence support was episodic and infrequent. However, the majority of pharmacists believed that it is their role to promote patients adherence. Time pressures for both pharmacists and patients were perceived to be a major barrier.
KeywordsAdherence Attitudes Australia Barriers Medications Pharmacists
The authors are grateful to all participating community pharmacists who completed and returned the questionnaires. We also thank the Faculty of Pharmacy, University of Sydney for their support.
Conflicts of interest
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
- 1.Improving adherence in cardiovascular care: a toolkit for health professionals. National Heart Foundation of Australia. 2011. ISBN: 978-1-921748-62-2.Google Scholar
- 2.Sabate E. Adherence to long-term therapies: evidence for action. World Health Organization. 2003. ISBN: 92-4-15499-2.Google Scholar
- 11.Saini B, Krass I, Smith L, Bosnic-Anticevich S, Armour C. Role of community pharmacists in asthma–Australian research highlighting pathways for future primary care models. Aust Med J. 2011;4(4):190–200.Google Scholar
- 14.Kristin NLDP, Ashen D. Key strategies to maximize adherence to secondary prevention therapies for coronory artery disease. 2011. Cited 11 Aug 2012. Available from http://www.medscape.org/viewarticle/736196.
- 19.Naing L, Winn T, Rusli B. Practical issues in calculating the sample size for prevalence studies. Arch Orofac Sci. 2006;1:9–14.Google Scholar
- 20.Nichols-English G, Poirier S. Optimizing adherence to pharmaceutical care plans. J Am Pharm Assoc. 2000;40(4):475–85.Google Scholar
- 24.Wetzels G, Nelemans P, van Wijk B, Broers N, Schouten J, Prins M. Determinants of poor adherence in hypertensive patients: development and validation of the “Maastricht Utrecht Adherence in Hypertension (MUAH)-questionnaire”. Patient Educ Couns. 2007;64(1):151–8.Google Scholar
- 25.Kotecki JE, Elanjian SI, Torabi MR. Health promotion beliefs and practices among pharmacists. J Am Pharm Assoc. 2000;40(6):773–9.Google Scholar
- 26.Lackey NR, Sullivan JJ, Pett MA. Making sense of factor analysis: the use of factor analysis for instrument development in health care research. California: Sage Publications Inc; 2003. ISBN: 978-0761919506.Google Scholar
- 27.Australian Institute of Health and Welfare 2009. Canberra: Australia`s Welfare 2009. AIWH Cat. No. AUS 117 Series no. 9; 2009. ISBN: 978-1-74024-956-0.Google Scholar
- 28.Guild Digest. A survey of independent pharmacy operations in Australia financial year 2009–10. Australia: The Pharmacy Guild of Australia; November 2011. ISSN: 1328-1895.Google Scholar