Pharmaceutical care in a community-based practice setting
in Iran: current status and future challenges
Gholamhossein Mehralian, Maryam Rangchian, Gita Afsharmanesh
and Narges Seifi
Department of Pharmacoeconomics and Pharmaceutical Policy, School of Pharmacy, Shahid Beheshti
University of Medical Sciences, Tehran, Iran
Abstract
Objectives This study aimed to evaluate pharmacists’ practice and attitude toward phar-
maceutical care (PhC) and present barriers in Iran.
Methods A cross-sectional descriptive study, inviting Iranian pharmacists, was conducted
using a self-administrated Likert-based questionnaire including demographic, performance,
attitude and barrier sections. Questionnaires were distributed and collected by research team.
Obtained data were analyzed through descriptive analysis, factor analysis, Friedman test and
χ
2
test.
Key findings Data on opinions of 986 pharmacists’ working in community pharmacies
located in 22 districts of Tehran were obtained. Findings in aspect of PhC implementation
showed that the frequency of the appropriate provision of PhC was less than 50% for making
contact with physician and medication monitoring. Speaking about attitude, the complete
agreement with ‘the practicability of the implementation of PhC’ and ‘the existence of
supportive manner among physicians towards pharmacists’ role’ was expressed only by 30.6
and 25.1% of respondents. Finally, according to participants concerns, the main barrier to
PhC was highlighted to be ‘patients reluctance in receiving pharmaceutical services’.
Conclusions It can be concluded that besides promotion of public awareness about PhC,
improvement of pharmacists’ motivation toward these services seems necessary. In addition,
further research is needed to explore the causes of non-promising relationship between
pharmacists and other health professionals, which, in turn, is critical to find appropriate
solutions.
Keywords attitude; barriers; community pharmacists; pharmaceutical care
Introduction
Providing high-quality and safe medical care is the primary goal of a healthcare system.
Many patients do not receive the optimum treatment due to drug-related problems (DRPs).
[1]
As an example, a study published in 2007 about hospital admissions caused by DRPs in
Isfahan showed that 92% of 115 examined DRP cases were either preventable or probably
preventable.
[2]
DRPs not only increase the rate of adverse effects but also impose huge
expenditures on the society. This happens while community pharmacists can play an effec-
tive role in the improvement of patients’ outcomes.
[3,4]
Pharmaceutical care (PhC), defined as
‘the responsible provision of medication-related care for the purpose of achieving definite
outcomes that can improve a patient’s quality of life’,
[5]
is one of the approaches suggested
to improve the level of society health. PhC provides healthcare systems with an opportunity
to benefit from pharmacists’ cooperation with patients and other healthcare professionals in
designing, implementing and monitoring the process of medication, which a majority of
related studies have confirmed its desirable effects on healthcare system outcomes.
[6–10]
Based on literature, in present study, three components were considered for PhC: data
gathering, managing DRPs and monitoring the treatment process.
[6–11]
Pharmacists are in a
position where they can deliver PhC at an acceptable level.
[12]
The usefulness of pharmacists’
interventions has been previously reported in some studies. For example, a study conducted
by Wu et al. showed that periodic telephone counseling by a pharmacist at the midpoint
between clinic visits led to significant improvement in patient adherence to the treatment,
Correspondence: Gholamhossein
Mehralian, School of Pharmacy,
Shahid Beheshti University of
Medical Science, Vali-e Asr Ave.,
Niayesh Junction, Tehran
1996814534, Iran.
E-mail: Gmehralian@gmail.com
Research Paper
JPHSR 2015, 6: 69–75
© 2015 Royal Pharmaceutical
Society
Received October 25, 2014
Accepted January 5, 2015
DOI 10.1111/jphs.12089
ISSN 1759-8885
69