Purpose

To assess the current practice of pharmaceutical care within community pharmacies throughout Ireland. Resources available to pharmacists, and pharmacists' opinions about the current practice of pharmaceutical care were evaluated.

Methods

Questionnaires with prepaid return envelopes were distributed once in mid January 2002 to all 1,148 community pharmacies registered with the Irish Pharmaceutical Union. All responses were anonymously evaluated. The questionnaire was based on the Republic of Irelands' Department of Health and Children's new Primary Care Health Strategy aims.

Results

Over half of the pharmacies responded (52%, 593/1148), of which 66% were under single-ownership, and 60% located in urban areas. The monthly average number of prescriptions dispensed was 2,229 (SEM 94.26). Proprietors made up 71% of the respondents, and nearly half of the respondents (47%) graduated from pharmacy school within the last 12 years.

Current practice

Nearly all pharmacists provide advice and monitor patients' progress through conducting drug therapy reviews (98%), and assess patients' needs for information about their medications (99%). Common services provided by pharmacists in promoting better health include advice on smoking cessation (99%), and usage of alcohol (86%), diet (96%), and exercise (88%). Monitoring of blood pressure (32%), blood glucose (19%), and cholesterol levels (9%) are also practiced. Among other special services, domiciliary visits and methadone supervision are provided by 35% and 28% of pharmacies respectively.

Current resource

Pharmaceutical care resources included consultation areas in 73% of pharmacies, however, 42% of pharmacists felt theirs was inadequate. At least one additional pharmacist is employed by 73% of pharmacies, and 30% of these employ at least one additional full-time pharmacist. Patient information on medical conditions, test results, and full medical records were accessible from medical practices to varying degrees by 62%, 42%, and 40% of the pharmacists respectively.

Opinion

Based on opinion statements regarding pharmacists' needs to practice pharmaceutical care effectively, pharmacists believe they are competent to maintain patient treatment plans (81%), and that they should be allowed to provide point-of-care testing (58%). Many pharmacists also believe that the elderly would benefit from domiciliary pharmacist visits (72%). Most pharmacists feel it is their role to advise GPs about the safe and effective use of medicines (90%), and to provide cost effective (73%) prescribing advice. The majority of pharmacists agree that a formal working relationship with GPs (82%), access to patient information (88%), and a consultation area (89%) is necessary to provide effective pharmaceutical care. Many find it difficult to have the protected time they feel is necessary to practice pharmaceutical care (53%), 80% would like to devolve some dispensing tasks to other employees, and 46% feel they need a second pharmacist for this purpose.

Conclusion

Community pharmacists feel they are capable and responsible for providing pharmaceutical care and are endeavouring to meet patients' needs with limited resources. Improvements in available resources and facilitated access to patient information from medical practices may optimise pharmacists' ability to practice more effective pharmaceutical care.