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Structural elements associated with the provision of phamaceutical care in community phamacy practice in Canada

University of British Columbia

The concept of pharmaceutical care is a philosophy of practice and has been presented to be an effective process for monitoring drug therapy to meet the needs of patients and the health care system. A number of pharmaceutical care models and practice guidelines have been proposed, developed and implemented in community pharmacy settings. As the pharmacy profession becomes more patient-focused using pharmaceutical care standards, it is important that pharmacists be able to assess the quality of that care and recognize the barriers that impede the provision of that care. Farris and Kirking maintain that Donabedian's structure-processoutcome paradigm can be applied to pharmaceutical care as a framework of quality assessment. Structure represents a necessary measure of quality and its assessment is crucial when structure can be associated with process and/or outcomes. This current study addresses the structure and process components of pharmaceutical care and reviews the structural elements that support the provision of pharmaceutical care in community pharmacy practice in Canada. This study examines the structural changes that have been made in community pharmacies that have adopted a pharmaceutical care model/program. A data collection instrument was developed which included the Community Pharmacy Structural Elements Questionnaire (CPSEQ) and the Behavioral Pharmaceutical Care Scale (BPCS). The CPSEQ was used to gather information regarding structural changes made in community pharmacies and the BPCS was used to gather information regarding pharmacists' efforts towards the provision of pharmaceutical care. The data collection instruments were administered to 261 community pharmacists across Canada who had been identified to have been affiliated with a pharmaceutical care model/program and were likely to have implemented pharmaceutical care practices. The instrument was also administered to a reference group of 197 community pharmacists who were not affiliated to any pharmaceutical care model/program. The information gathered was used to determine the most frequent structural elements observed in community pharmacies that had implemented a pharmaceutical care model/program and in progressive community pharmacies that were actively providing pharmaceutical care. The exploratory analysis revealed the presence of progressive community pharmacy practices in Canada that were actively making structural changes and providing pharmaceutical care. Among the structural changes that were consistently reported in these community pharmacy practices were re-organization of pharmacists' duties, re-organization of pharmacy technicians' duties, formal training program for pharmacists, on-the-job training for pharmacy technicians, incorporation of a private or semi-private counselling room, and incorporation of audio-visual educational equipment.

Thesis/Dissertation

application/pdf

2009-08-14

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http://hdl.handle.net/2429/12201

Pharmaceutical Sciences

University of British Columbia

UBCV

DSpace