Skip to main content

Provision of pharmaceutical care by community pharmacists: a comparison across Europe


Objective To investigate the provision of pharmaceutical care by community pharmacists across Europe and to examine the various factors that could affect its implementation. Methods A questionnaire-based survey of community pharmacies was conducted within 13 European countries. The questionnaire consisted of two sections. The first section focussed on demographic data and services provided in the pharmacy. The second section was a slightly adapted version of the Behavioral Pharmaceutical Care Scale (BPCS) which consists of three main dimensions (direct patient care activities, referral and consultation activities and instrumental activities). Results Response rates ranged from 10–71% between countries. The mean total score achieved by community pharmacists, expressed as a percentage of the total score achievable, ranged from 31.6 (Denmark) to 52.2% (Ireland). Even though different aspects of pharmaceutical care were implemented to different extents across Europe, it was noted that the lowest scores were consistently achieved in the direct patient care dimension (particularly those related to documentation, patient assessment and implementation of therapeutic objectives and monitoring plans) followed by performance evaluation and evaluation of patient satisfaction. Pharmacists who dispensed higher daily numbers of prescriptions in Ireland, Germany and Switzerland had significantly higher total BPCS scores. In addition, pharmacists in England and Ireland who were supported in their place of work by other pharmacists scored significantly higher on referral and consultation and had a higher overall provision of pharmaceutical care. Conclusion The present findings suggest that the provision of pharmaceutical care in community pharmacy is still limited within Europe. Pharmacists were routinely engaged in general activities such as patient record screening but were infrequently involved in patient centred professional activities such as the implementation of therapeutic objectives and monitoring plans, or in self-evaluation of performance.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2


  1. Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47:533–43.

    CAS  PubMed  Google Scholar 

  2. Strand LM, Morley PC, Cipolle RJ, Ramsey R, Lamsam GD. Drug-related problems: their structure and function. DICP. 1990;24:1093–7.

    CAS  PubMed  Google Scholar 

  3. Rovers PR, Currie JD, Hagel HP, McDonough RP, Sobotka JL. A practical guide to pharmaceutical care. Washington: The American Pharmaceutical Association; 1998.

    Google Scholar 

  4. Odedina FT, Segal R. Behavioral pharmaceutical care scale for measuring pharmacists’ activities. Am J Health Syst Pharm. 1996;53:855–65.

    CAS  PubMed  Google Scholar 

  5. Penna RP. Pharmaceutical care: pharmacy’s mission for the 1990 s. Am J Hosp Pharm. 1990;47:543–9.

    CAS  PubMed  Google Scholar 

  6. Bagozzi RP. The self-regulation of attitudes, intentions, and behavior. Soc Psychol Q. 1992;55:178–204.

    Article  Google Scholar 

  7. Raisch DW. Barriers to providing cognitive services. Am Pharm. 1993;NS33:54–8.

    CAS  PubMed  Google Scholar 

  8. Reutzel TJ. The compatibility of the retail setting with a patient-based practice model: Reports from community pharmacists. J Clin Pharm Ther. 1994;19:301–12.

    Article  CAS  PubMed  Google Scholar 

  9. Elnour AA, El Mugammar IT, Jaber T, Revel T, McElnay JC. Pharmaceutical care of patients with gestational diabetes mellitus. J Eval Clin Pract. 2008;14:131–40.

    CAS  PubMed  Google Scholar 

  10. Roughead EE, Semple SJ, Vitry AI. Pharmaceutical care services: a systematic review of published studies, 1990 to 2003, examining effectiveness in improving patient outcomes. Int J Pharm Pract. 2005;13:53–70.

    Article  Google Scholar 

  11. Lambert BL. Face and politeness in pharmacist-physician interaction. Soc Sci Med. 1996;43:1189–98.

    Article  CAS  PubMed  Google Scholar 

  12. Rossing C, Hansen EH, Krass I. The provision of pharmaceutical care in Denmark: a cross-sectional survey. J Clin Pharm Ther. 2003;28:311–8.

    Article  CAS  PubMed  Google Scholar 

  13. Bell HM, McElnay JC, Hughes CM, Woods A. Provision of pharmaceutical care by community pharmacists in Northern Ireland. Am J Health Syst Pharm. 1998;55:2009–13.

    CAS  PubMed  Google Scholar 

  14. Robinson JP, Shaver PR, Wrightsman LS. Criteria for scale selection and evaluation. In: Robinson JP, Shaver PR, Wrightsman LS, editors. Measures of personality and social psychological attitudes, vol. 1. San Diego: Academic Press; 1991. p. 1–15.

    Google Scholar 

  15. Costello AB, Osborne W. Best practices in exploratory factor analysis: four recommendations for getting the most from your analysis. Pract Assess Res Eval. 2005;10:1–9.

    Google Scholar 

  16. Kaiser HF. An index of factorial simplicity. Pschometrika. 1974;39:31–6.

    Article  Google Scholar 

  17. Cipolle RJ, Strand LM, Morley PC. Pharmaceutical care practice. New York: McGraw Hill Higher Education; 1998.

    Google Scholar 

  18. Odedina FT, Segal R, Hepler CD. Providing pharmaceutical care in community practice: differences between providers and non-providers of pharmaceutical care. J Soc Admin Pharm. 1995;12:170–80.

    Google Scholar 

  19. Harris WE, Rivers PH, Goldstein R. The potential role of community pharmacists in care management. Health Soc Care Commun. 1998;6:196–203.

    Article  Google Scholar 

  20. van Mil JW, Westerlund LO, Hersberger KE, Schaefer MA. Drug-related problem classification systems. Ann Pharmacother. 2004;38:859–67.

    Article  PubMed  Google Scholar 

  21. Farris KB, Fernandez-Llimos F, Benrimoj SI. Pharmaceutical care in community pharmacies: Practice and research from around the world. Ann Pharmacother. 2005;39:1539–41.

    Article  PubMed  Google Scholar 

  22. Fowler FJ. Survey research methods. 3rd ed. London: Sage Publications; 2002.

    Google Scholar 

Download references

Conflicts of interest statement

None declared.


All national studies were funded locally by the researchers. Coordination of the studies was not funded separately.

Author information

Authors and Affiliations


Corresponding author

Correspondence to James C. McElnay.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Hughes, C.M., Hawwa, A.F., Scullin, C. et al. Provision of pharmaceutical care by community pharmacists: a comparison across Europe. Pharm World Sci 32, 472–487 (2010).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • Community pharmacy
  • Europe
  • Pharmaceutical care
  • Pharmacists