Enhanced pharmacy services, barriers and facilitators in Australia's community pharmacies: Australia's National Pharmacy Database Project

Abstract

Abstract Objective To report the frequency of 27 enhanced pharmacy services (EPS) provided in Australia's community pharmacies and to analyse barriers and facilitators for providing priority services. Setting A large representative sample of community pharmacies in Australia in 2002. Method Questionnaires were mailed to owners or managers of a stratified, representative sample of Australia's community pharmacies; 1131of 1391 consenting pharmacies responded (81.3%). Specifically trained staff, fees charged, structural and other components and plan to introduce EPS were analysed. The barriers and facilitators for all EPS were rated by a Likert scale. Logistic regression models tested for predictors for providing one or more EPS and those related to Australia's National Health Priorities. Key findings Eighty-eight per cent of Australia's community pharmacies offered ≥1 EPS. More than 40% offered EPS for asthma, diabetes, methadone, herbal medicines, hypertension and wound care. Pharmacies with higher turnover (odds ratio (OR), 1.90; 99% confidence interval (CI) = 1.05–3.42) and younger owners (OR for age, 0.69; 99% CI = 0.48–0.99) were predictors for providing ≥1 EPS. Higher turnover was a predictor for diabetes care. Enclosed counselling area was a predictor for hypertension care. Owners and managers committed to continuing education was a predictor for diabetes and hyperlipidaemia services. Significant barriers perceived were lack of confidence for diabetes care and not being regarded as ‘part of the job’ for asthma, diabetes, hypertension and weight-management services. Conclusion The percentages of pharmacies in Australia that provided equivalent EPS were similar or higher than the UK, New Zealand and USA. The frequency of existing and planned EPS appeared disproportionately low to satisfy national health priorities. Significant barriers and facilitators and pharmacy characteristics for providing EPS were identified. The results assist national bodies to increase the uptake of EPS by pharmacies.