Pharmacists' perceptions regarding their contribution to improving the public's health: a systematic review of the United Kingdom and international literature 1990–2001

Abstract

Abstract Objective To systematically review, summarise and evaluate the published evidence from 1990–2001 relating to pharmacists' attitudes towards and perceptions of their role in improving the public's health. Methods Electronic databases searched were MEDLINE, EMBASE, Cochrane Library and International Pharmaceutical Abstracts. Hand searches were undertaken of a number of relevant journals and conference abstracts. Studies on pharmacy and health education, health promotion, public health, smoking cessation, diet, body weight, and coronary heart disease were identified. All relevant studies with an English language abstract were included. Two of the authors separately examined the lists of titles and abstracts of papers from the searches and then compared inclusion/ exclusion lists and resolved any differences by discussion. Two approaches were used to assess the quality of the evidence and each study was allocated an evidence grade. Data were abstracted into a matrix and a narrative report constructed to synthesise the evidence. Key findings The search identified 12 studies (nine from the UK and three from other countries), all of which involved community pharmacists. Pharmacists attach a high degree of importance to health improvement activities. They are more comfortable with activities that are related to medicines and need support to extend their range of health-related work. Pharmacists' advice is more likely to be reactive than proactive; their concerns about being “intrusive” in offering potentially unwelcome health advice predisposes to a reactive stance. While dispensing duties were widely reported by pharmacists as a key barrier to greater involvement in activities that improve the public's health, the review of the evidence showed that perceptions and attitudes are also key to pharmacists' behaviour in relation to these activities. Conclusion Community pharmacists' activities in improving the public's health centre around medicines. This is unsurprising, as dispensing and sale of medicines constitute a pharmacist's core business, and are the areas that they are perceived to be expert in and in which they have received the most training. If pharmacists are to contribute to wider public health activities, ways need to be found of extending their sphere of activity. The review findings have implications for those involved in education and training of pharmacists at undergraduate and postgraduate levels.