Skip to main content

Advertisement

SpringerLink
Log in

Pharmacists’ attitudes and perceived barriers to provision of adherence support in Australia

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

Abstract

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.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Improving adherence in cardiovascular care: a toolkit for health professionals. National Heart Foundation of Australia. 2011. ISBN: 978-1-921748-62-2.

  2. Sabate E. Adherence to long-term therapies: evidence for action. World Health Organization. 2003. ISBN: 92-4-15499-2.

  3. Reid D, Abramson M, Raven J, Walters HE. Management and treatment perceptions among young adults with asthma in Melbourne: the Australian experience from the European community respiratory health survey. Respirology. 2000;5(3):281–7.

    Article  CAS  PubMed  Google Scholar 

  4. Cramer JA. A systematic review of adherence with medications for diabetes. Diabetes Care. 2004;27(5):1218–24.

    Article  PubMed  Google Scholar 

  5. Bauman LJ, Wright E, Leickly FE, Crain E, Kruszon-Moran D, Wade SL, et al. Relationship of adherence to pediatric asthma morbidity among inner-city children. Pediatrics. 2002;110(1):6.

    Article  Google Scholar 

  6. Miura T, Kojima R, Mizutani M, Shiga Y, Takatsu F, Suzuki Y. Effect of digoxin noncompliance on hospitalization and mortality in patients with heart failure in long-term therapy: a prospective cohort study. Eur J Clin Pharmacol. 2001;57(1):77–83.

    Article  CAS  PubMed  Google Scholar 

  7. Osterberg L, Blaschke T. Adherence to medication. NEJM. 2005;353:487–97.

    Article  CAS  PubMed  Google Scholar 

  8. Kripalani S, Yao X, Haynes RB. Interventions to enhance medication adherence in chronic medical conditions: a systematic review. Arch Intern Med. 2007;167(6):540–50.

    Article  PubMed  Google Scholar 

  9. Baroletti S, Dell’Orfano H. Medication adherence in cardiovascular disease. Circulation. 2010;121(12):1455–8.

    Article  PubMed  Google Scholar 

  10. Mansoor SM, Krass I, Aslani P. Multiprofessional interventions to improve patient adherence to cardiovascular medications. J Cardiovasc Pharmacol. 2012;18(1):19–30. doi:10.1177/1074248412442001.

    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.

    CAS  Google Scholar 

  12. Lindenmeyer A, Hearnshaw H, Vermeire E, Van Royen P, Wens J, Biot Y. Interventions to improve adherence to medication in people with type 2 diabetes mellitus: a review of the literature on the role of pharmacists. J Clin Pharm Ther. 2006;31(5):409–19.

    Article  CAS  PubMed  Google Scholar 

  13. Carter BL, Elliott WJ. The role of pharmacists in the detection, management, and control of hypertension: a national call to action. Pharmacotherapy. 2000;20(2):119–22.

    Article  CAS  PubMed  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.

  15. Carter BL, Zillich AJ, Elliott WJ. How pharmacists can assist physicians with controlling blood pressure. J Clin Hypertens. 2003;5(1):31–7.

    Article  Google Scholar 

  16. Rouse MJ. Continuing professional development in pharmacy. J Am Pharm Assoc. 2004;44(4):517–20.

    Article  Google Scholar 

  17. Ho PM, Bryson CL, Rumsfeld JS. Medication adherence. Circulation. 2009;119(23):3028–35.

    Article  PubMed  Google Scholar 

  18. Burns K, Turnbull F, Patel A, Peiris D. Opinions of community pharmacists on the value of a cardiovascular polypill as a means of improving medication compliance. Int J Pharm Pract. 2012;20(3):155–63.

    Article  PubMed  Google Scholar 

  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.

    CAS  Google Scholar 

  21. Ammassari A, Trotta MP, Murri R, Castelli F, Narciso P, Noto P, et al. Correlates and predictors of adherence to highly active antiretroviral therapy: overview of published literature. J Acquir Immune Defic Syndr. 2002;31(15):S123–7.

    Article  PubMed  Google Scholar 

  22. Haynes RB, McDonald H, Garg A, Montague P. Interventions for helping patients to follow prescriptions for medications. Cochrane Database Syst Rev. 2002;2:CD000011.

    PubMed  Google Scholar 

  23. Zyczynski TM, Coyne KS. Hypertension and current issues in compliance and patient outcomes. Curr Hypertens Rep. 2000;2(6):510–4.

    Article  CAS  PubMed  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.

    CAS  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.

  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.

  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.

  29. Guy M, Boesen K. Attitudes toward and factors affecting implementation of medication therapy management services by community pharmacists. J Am Pharm Assoc. 2009;49:26–30.

    Article  Google Scholar 

  30. Possidente CJ, Anzisi L, Algozzine TW, Buckley TE, Weathermon R. Pharmacists’ activities supporting medication adherence: a regional survey. J Am Pharm Assoc. 2005;45(6):743–5.

    Article  Google Scholar 

  31. Benrimoj SI, Frommer MS. Community pharmacy in Australia. Aust Health Rev. 2004;28(2):238–46.

    Article  PubMed  Google Scholar 

  32. 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  PubMed  Google Scholar 

  33. Peterson-Clark G, Aslani P, Williams KA. Pharmacists’ online information literacy: an assessment of their use of Internet based medicines information. Health Info Libr J. 2010;27(3):208–16.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

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.

Funding

None.

Conflicts of interest

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Author information

Authors and Affiliations

  1. Faculty of Pharmacy, The University of Sydney, Building A15, Sydney, NSW, 2006, Australia

    Sarab M. Mansoor, Parisa Aslani & Ines Krass

Authors
  1. Sarab M. Mansoor
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Parisa Aslani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ines Krass
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sarab M. Mansoor.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mansoor, S.M., Aslani, P. & Krass, I. Pharmacists’ attitudes and perceived barriers to provision of adherence support in Australia. Int J Clin Pharm 36, 136–144 (2014). https://doi.org/10.1007/s11096-013-9840-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-013-9840-6

Keywords

Search

Navigation