Sexual health advice is a service community pharmacists would like to provide in the future, according to the first baseline research into community pharmacy practice in Ireland which has been presented to the Minister for Health Mr Reilly by the PSI.
The research found a perception that pharmacy is under-valued and under-appreciated in the current healthcare structure and that the top three services not currently provided, but which pharmacists would like to provide in future, consist of Lung Capacity Screening, Sexual Health, and Structured Medicine Use Reviews.
The main barrier to providing enhanced pharmacy services was identified as being finance and a lack of qualified staff according to respondents in the report. Other potential barriers included opposition by local GPs and other healthcare providers.
The main findings relating to the inter-professional relationships found that the majority of pharmacists were either satisfied (32.2%) or very satisfied (28.2%) with their relationship with local doctors although 94.6% said they did not have engagement with local multi-professional groups and 91.6% of pharmacists indicated they had no engagement with patient support groups. The main findings relating to the use of information technology found that many pharmacists felt that access to at least some patient data held by GPs and others would be helpful to their practice.
In general, pharmacists felt their interactions with their GPs were cordial, that the relationship involved mutual respect, that the communication was good, and that they could work together for patients’ benefit. On average, there were found to be two pharmacists reported as working in each pharmacy (the maximum reported number of pharmacists was 5). When asked what, if anything, they would change about the workforce in the pharmacy, most pharmacists responded that they would take on more staff, specifically pharmacists with the ability to develop new services.
99.8% of the respondents reported that they had practised in community pharmacy, 23.4% indicated they had undertaken hospital pharmacy, 5.8% had worked in industry, and another 4.5% in research. Almost 39% of respondents were aged under 35, with 35% being aged between 35 and 44.
On average, older patients made up 60% of respondents’ patient profiles, with families with young children representing 26.7%, younger patients (12-30) making up 16.2%, and patients in residential care 5.4%. Pharmacists indicated that repeat or regular patients make up 78% on average of the pharmacy patient profile.
“Many respondents felt that the pharmacist is currently under-utilised and that there is potential to expand the role of pharmacy in healthcare services to patients,” said PSI Registrar/CEO Dr Ambrose McLoughlin. “When looking at the development of further services, we need to focus on ways to encourage the provision of enhanced pharmacy services. Potential mechanisms include the development of standards and the design of specific training programmes. The imminent development of, for example, mandatory CPD requirements and the establishment of the Institute of Pharmacy which will manage the new CPD system will support the development of pharmacy practice. This survey has given us a valuable and unprecedented insight into pharmacy in Ireland and there is now considerable merit in the PSI repeating this survey in 2015, to track any changes which have occurred in the intervening 4 years, so that trends can be identified. We will also be carrying out a similar study of hospital pharmacy practice in Ireland this year.”
The PSI commissioned Horwath Bastow Charleton (HBC) in late 2009 to conduct the study. The first phase of the study focused on the provision of core and extended pharmacy services in Ireland. The second phase was designed to be an international review study, examining pharmacy provision and regulation in other EU countries, Australia, Canada, New Zealand. The data collection was carried out through a census survey of all community pharmacies and follow-up interviews with approximately 40 community pharmacies across the country.
Over 60% of pharmacists responding to the survey stated that enablers to better uptake of Continuing Professional Development (CPD) would include availability closer to their pharmacy, greater frequency/more convenient times, an enhanced range of topics, or online/technology-based learning. The most commonly-identified barrier to CPD for 83.9% of pharmacists was lack of time. There was near-universal agreement that future service development, especially into screening and diagnostic services, would require specific CPD resources to support this.
26.5% of respondents had prescription dispensing numbers in excess of 5,000 per month with GMS prescriptions representing the largest numbers for pharmacies’ dispensing activity. The report stated that pharmacists spend most of their professional time during normal working hours on dispensing prescription medicines, counselling prescription patients, counselling non-prescription patients, and giving advice about minor illness.
Many of the comments from pharmacists referred to a time of intense pressure on pharmacy and pharmacists. Financial pressure and the difficulties in the relationship with the State feature strongly. There is uncertainty among many pharmacists as to how things will develop, making it difficult for them to plan and have stability. Several respondents indicated a desire to see closer integration of pharmacy into the primary healthcare structure, working more closely with GPs and other healthcare providers in a multi-disciplinary team set-up.
For a full overview of the findings and to view the report, go to the PSI website www.thePSI.ie.