Background

Pharmacy services develop as a part of the implementation of policy within the Welfare state, thus, a study of their development should consider the factors that influence policy implementation. Hogwood and Gunn identify 'no resistance to the policy' for successful policy implementation (Hogwood & Gunn, 1984). The Royal Pharmaceutical Society of Great Britain (RPSGB) launched the Pharmacy in a New Age (PIANA) initiative in 1995. At the end of the consultation phase five extended roles were identified (RPSGB, 1997). Research was conducted to determine potential areas of resistance in considers pharmacist's acceptance of the extended roles.

Objectives

To inform the health policy process of pharmacists' perceptions of the importance of extended services as identified in the PIANA initiative.

Method

Self-completed postal questionnaire, allowing the ranking of the following pharmacy roles from most important to fifth most important; management of prescribed medicines, management of long term conditions, management of common ailments, promotion of healthy lifestyles and advice and support of other health care. Significance was set at the 95% confidence interval for avoiding a type one error.

Sample

The study group comprised two thousand three hundred and fifty nine pharmacists living in Great Britain who were registered with the RPSGB on March 12^th 1999.

Key findings

The response rate was 60.1% (n=1182). Statistical analysis demonstrated that that pharmacists agreed:

• the most important role was the management of prescribed medicines;
• the second most important was the management of common ailments;
• the third most important was advice and support of health care professionals;
• the forth most important was the management of long term conditions; and,
• the fifth most important was the promotion of healthy lifestyles.

Inspection of adjusted standardized residuals in contingency tables identified that the variation of ranking and epidemiological attributes of pharmacists accounted for the following significant associations:

• male pharmacists ranked the PIANA role advice and support of health care professionals more important than female pharmacists;
• the ranking of the management of common ailments was perceived as more important than expected by community pharmacists and less important by hospital pharmacists than expected;
• the ranking of the promotion of healthy lifestyles was considered more important by community pharmacists and less important by hospital pharmacists than expected;
• the advice and support of health care professionals was perceived as being more important by hospital pharmacists and less important by community pharmacists than expected.

Conclusion

The management of prescribed medicines is considered the most important role by all sectors of the profession. Policy should consider developing roles that are supported by those responsible for implementing them and focus initially on the one supported by all. It should be noted that the perspective of pharmacists involved in the policy process may not represent those expected to implement the policy,

References

Hogwood, B.W. & Gunn, L.A. (1984) Policy analysis for the real world. Oxford University Press, Oxford.

RPSGB (1997) Building the future, a strategy for a 21^st Century pharmaceutical service. London, RPSGB.