Workload pressure among recently qualified pharmacists: An exploratory study of intentions to leave the profession

Alienation and/or anomie in pharmacists: A systematic review and narrative synthesis of the international literature

BACKGROUND

Flourishing and belonging are key concepts for the wellbeing of staff and the success of a profession. Alienation and anomie are distinct types of psycho-social ills which inhibit flourishing and belonging. A better understanding of these may offer hope in preventing many negative work endpoints, including burnout and intention to leave.

OBJECTIVES

To systematically review and narratively synthesise alienation and/or anomie in pharmacists across the globe, reviewing all types of methodological designs, published in peer-reviewed journals.

METHODS

We identified published peer-reviewed research through searching eight electronic databases (MEDLINE, Embase, PsycINFO, CINAHL, Cochrane Library, Web of Science - Core Collection, Scopus, and Google Scholar) and extensive hand/citation searching. Two independent reviewers identified and critiqued eligible studies, extracted data, and synthesised the findings. The synthesis evaluated the focuses, causes, associated factors, and/or consequences of alienation and/or anomie and aligned these to six deductive themes from alienation theory: care; values; meaning; recognition; autonomy; and shared responsibility.

RESULTS

Searches identified 886 papers, with 47 included in the final results. From the synthesis, ten key causes of alienation and/or anomie were identified; 1) Changing Professional Identity, 2) Reimbursement Models & Corporatisation, 3) Focus on Medicines Rather than People, 4) Misunderstanding & Deprofessionalisation, 5) Environments & Culture, 6) Suboptimal Societal Mandate, 7) Roles Misaligned with Aspirations, 8) Systematic Underutilisation, 9) Lack of Professional Agency, and 10) Value Conflict. From the evidence, there was high confidence that inhibitions of care, values, recognition, and/or autonomy (four of the six deductive themes) were associated with alienation and/or anomie.

CONCLUSION

Alienation and/or anomie are present across many countries and regions. This paper helps us understand the aetiology of this complex psycho-social syndrome, a necessary first step in creating an inclusive profession where all pharmacists can flourish. Future research needs to trial new interventions targeted at correcting this professional malady.

Unveiling the Exodus: A scoping review of attrition in allied health

BACKGROUND

Efficient utilisation of allied health workforce may help address the predicted shortfall of 18 million health workers estimated by 2030. Knowledge about allied health professionals' attrition, or intention to leave, and factors influencing attrition can assist in developing evidence-informed strategies to mitigate this issue. The review aimed to map attrition and attrition intention rates, and its attributing factors for allied health professions worldwide.

METHODS

Adhering to the PRISMA-ScR guidelines, a comprehensive search was conducted across academic databases (PsycINFO, MEDLINE, Embase, Emcare, CINAHL, Scopus, and the Cochrane Library database) and grey literature (Google, Google Scholar, organisational websites). Two reviewers independently undertook a two-stage screening process along with data extraction using customised data extraction forms. A narrative synthesis was used to synthesise the data.

RESULTS

Thirty-two studies published between 1990 and 2024 were included. Attrition rates ranged from 0.5% to 41% across allied health disciplines. Pharmacists demonstrated the lowest attrition rates, while audiologists reported the highest. Radiographers reported the lowest intent to leave at 7.6%, while occupational therapists showed highest intent to leave, ranging from 10.7% to 74.1%. The analysis revealed three recurring themes contributing to attrition: profession-centric factors (e.g., career progression, job satisfaction, support, and professional growth), systemic-centric factors (e.g., compensation, staffing challenges, clinical practices, patient care, workload), and individual-centric factors (e.g., recognition, the need for change, and burnout).

CONCLUSION

Attrition in allied health remains a significant challenge. Addressing this issue requires a systemic, nuanced, and evidence-based approach, given the complex, interlinked, and multifaceted factors contributing to attrition. The younger workforce, characterized by changing generational values, necessitates innovative thinking, intersectoral collaboration, and the potential for co-created solutions with, for, and by the allied health workforce.

"We're seen as part of the supply chain of medicines rather than as the professionals that we are": The wellbeing of community pharmacists during the COVID response

INTRODUCTION

Challenges facing community pharmacists in delivering and adapting services during the COVID-19 response have been reported. However, few qualitative studies have examined the impact of these experiences on their wellbeing, and what supports the profession requires in the future.

AIM(S)

To examine the work-related experiences and psychosocial needs of community pharmacists situated in the Republic of Ireland arising from the COVID-19 response.

METHOD

11 pharmacists and 1 representative were interviewed and data analysed through inductive thematic analysis.

RESULTS

Work experiences were characterised by increased workload linked to multiple roles pharmacists played during the pandemic. Remaining open, meeting the social and medical needs of patients unable to easily access other primary services exerted its toll on pharmacists while at the same time providing a sense of professional fulfilment. Participants felt contributions made to the community during COVID-19 went largely unrecognised by the wider healthcare structure. This added to a prior sense of professional disenchantment arising from long-standing under-resourcing, lack of clinical autonomy and high administrative burden eroding their sense of purpose and meaning. Informal, peer-support networks were preferred over formal psychological support initiatives.

CONCLUSIONS

The post-pandemic environment is an opportune time for policy makers to reconsider the role of community pharmacists. Greater clinical autonomy beyond dispensing of medicines, for example, for example, would also serve to enhance the sense of purpose and meaning of pharmacists as healthcare professionals. The longer-term well-being of community pharmacists is contingent on recognition of the value that community pharmacy bring both to the healthcare system and wider society as a whole.

Development of a quality of work life scale for Japanese community pharmacists: a questionnaire survey mostly in large companies

BACKGROUND

Human resource management may become complex for community pharmacists owing to recent changes in work volume and content. Few studies have examined job satisfaction, well-being, and quality of work life (QWL) among community pharmacists in Japan. This study focused on QWL, a more comprehensive concept than job satisfaction, and aimed to develop the QWL questionnaire for Japanese community pharmacists (the QWLQ for JCP) and assess its reliability and validity.

METHODS

A questionnaire survey was conducted among 2027 pharmacists who worked in pharmacies with the cooperation of 20 corporations running pharmacies. Collected data were subjected to principal component factor analysis with Promax rotation via SPSS Windows version 28.

RESULTS

The factor analysis used data from 1966 pharmacists. In total, five significant components, which formed the basis of the QWLQ for JCP, were identified. These included "Influence of work on mind and body," "Relationships with colleagues," "Relationship with the boss," "Meaning of existence in the workplace," and "Pride in work." Cronbach's alpha, which expressed reliability, ranged from 0.585 to 0.854 for all the subscales.

CONCLUSION

The QWLQ for the JCP significantly explained the concept of QWL, which indicated that its validity was sufficient.

A narrative review of the well-being and burnout of U.S. community pharmacists

OBJECTIVES

The purpose of this narrative review is to summarize the literature on well-being and burnout among community pharmacists in the U.S. and provide recommendations for future research.

METHODS

Relevant literature was identified by searching PubMed for combinations of keywords such as "burnout" and "well-being" combined with "pharmacists." Titles and abstracts were reviewed for relevancy, and full text articles were reviewed when applicable.

RESULTS

While burnout is defined by its 3 core symptoms of emotional exhaustion, depersonalization, and low personal accomplishment, well-being is more challenging to define and measure, which has led to it being less studied. Community pharmacists faced high rates of burnout, low quality of life (QOL), and extreme fatigue prior to the COVID-19 pandemic, a situation that has likely only worsened. Factors such as workload, the type of community pharmacy, the level of education or training of the pharmacist, and stress may be some of the contributors to high rates of burnout. Clinician burnout may be related to high rates of mental health disorders seen in pharmacists, may impact patient safety and satisfaction, and may affect productivity and costs to employers and the healthcare system overall. There has been no research into interventions or strategies to support well-being and reduce burnout among community pharmacists, but having a workplace that is perceived as supporting well-being may have some impact. Recommendations for future research include the following: (1) define well-being, (2) explore why various factors support well-being or contribute to burnout, (3) determine the impact of community pharmacists experiencing well-being or burnout, and (4) develop strategies to support well-being and reduce burnout that are specific to community pharmacy.

CONCLUSION

There is a sparsity of evidence regarding community pharmacist well-being and burnout. Further research is needed to generate the evidence needed to support interventions that are specific to the unique work setting of community pharmacists.

Community Pharmacies' Promotion of Smoking Cessation Support Services in Saudi Arabia: Examining Current Practice and Barriers

BACKGROUND

Community pharmacists' interventions have been found to be highly effective. However, to date, there has been little information about pharmacists' potential roles and perceived barriers to providing smoking cessation. This study aimed to assess the potential role of community pharmacists in supporting their patients to quit smoking by summarizing their self-reported level of current activities, confidence, and perceived barriers; Methods: A self-administered questionnaire was used for a cross-sectional study in Saudi Arabia. As part of the questionnaire, demographic characteristics were measured, as well as confidence, perceived berries, and level of smoking cessation activities (asking, advising, assessing, assisting, and arranging, including follow-up).; Results: 370 community pharmacists practicing responded to the survey. Pharmacists indicated high activity rates about advising and assessing patients in quitting smoking, with lower rates of assisting and arranging, including following up. The rate of recording smoking status was very low. There were significant differences between gender, source of education, years practicing as a licensed pharmacist, attended an education or training program on smoking cessation, and interest in providing smoking and perceived practice of smoking cessation. Pharmacists are confident about providing smoking cessation activities. Barriers to providing smoking cessation services include unable to follow up, lack of counseling space, lack of educational materials, and lack of time.; Conclusions: Saudi Arabian community pharmacists actively offer smoking cessation services, which may reduce smoking-related health issues. It appears that pharmacists need to be empowered by team-based, systematic, comprehensive approaches to overcome barriers and enhance their confidence.

The stress, satisfaction and fulfilment of early career pharmacists - a qualitative analysis of a survey on their professional and personal lives

OBJECTIVES

This study aims to examine and develop a better understanding of (1) the factors that affect the stress of both their professional and personal lives, (2) the aspects of professional and personal life that affect their satisfaction and fulfilment and (3) what they need to achieve satisfaction and fulfilment in their professional and personal lives.

METHODS

A cross-sectional study using a questionnaire was developed. The questionnaire contained 8 questions designed to collect qualitative data on the factors affecting the stress, satisfaction and fulfilment in the professional and personal lives of early career pharmacists (ECPs). Questionnaire responses were analysed using a qualitative content analysis approach and themes describing influential factors were developed.

KEY FINDINGS

Some of the factors that contribute to the stress, satisfaction and fulfilment of ECPs were identified. The stressors identified include the workplace environment and relationships with colleagues, the demands of a pharmacist career, the lack of career advancement pathways, job insecurity, relationships and their weaknesses. Factors contributing to satisfaction and fulfilment included supportive work environments and relationships, being appreciated and making a difference, growth, supportive relationships and self-care.

CONCLUSIONS

Supporting the well-being of ECPs is important for a resilient, engaged and effective pharmacy workforce. Key interventions include eliminating job insecurity, establishing clear career pathways, improving work environments and relationships and investing in the development of clinical, technical, communication and managerial skills.

Primary Healthcare Pharmacists' Perceived Organizational Support and Turnover Intention: Do Gender Differences Exist?

Purpose

This study aims to explore the relationship between the four-dimensional structured perceived organizational support (emotional support, instrumental support, supervisor support, and coworker support) and the turnover intention of pharmacists in primary healthcare institutions. The gender differences between perceived organizational support and turnover intention will also be examined.

Methods

A cross-sectional study was conducted in primary healthcare institutions of 31 cities in China from 2 July to 1 September 2021. And the binary logistic regression model was employed for data analysis.

Results

937 valid questionnaires are allocated from pharmacists in primary healthcare institutions. The regression results indicated that emotional support (b=0.073, p<0.001) has a significant influence on pharmacists' turnover intention, and the effect of supervisor support (b=0.173, p=0.046) on pharmacists' turnover intention differs by gender.

Conclusion

These findings offer suggestions for the management and stabilization of pharmacists in primary healthcare institutions. It is suggested that specific measures should be taken to increase pharmacists' perceived organizational support and reduce their turnover intention. At the same time, gender differences need to be taken into consideration by the managers when providing perceived organizational support to reduce their turnover intention through adaptive management.

Workplace violence against pharmacists: A systematic review and meta-analysis

BACKGROUND

The rate of violence against health care workers is increasing worldwide. Pharmacists are the most accessible and frequently visited health care team members and are potentially more susceptible to violence than other health care workers.

OBJECTIVE(S)

This systematic review and meta-analysis aimed to estimate the magnitude of workplace violence toward pharmacists.

METHODS

We comprehensively searched PubMed, Scopus, and Embase from their inception till December 2021 for pertinent studies that reported workplace violence incidents against pharmacists. Rates of workplace violence against pharmacists were calculated in a meta-analysis using a random-effects model.

RESULTS

Overall, 624 articles were found, and 6 studies comprising 1896 pharmacists met the criteria for meta-analysis. The pooled estimate of workplace violence was 45% (95% confidence interval [CI]: 30-60%), and 39% (95% CI: 24-55%) experienced violent events over preceding 12 months. Considerable proportion of pharmacists experienced some form of violence (65%, 95% CI: 41-88%), verbal abuse (50%, 95% CI: 36-65%), threats (42%, 95% CI: 26-59%) or assaults (27%, 95% CI: 9-46%). Moreover, 56% (95% CI: 23-89%) of pharmacists reported experiencing physical and/or verbal violence over the previous 12 months.

CONCLUSION

The analysis reveals the high rate of workplace violence in the pharmacy environment, with nearly half of pharmacists affected. While more studies are required, the limited evidence suggests the need to ensure safe workspaces in pharmacy environments through implementation of appropriate policies and legislation.

Exploring job satisfaction among pharmacy professionals in the Arab world: a multi-country study

Objectives

The study objectives were to (1) describe the characteristics of the pharmacy professionals and (2) explore the association between job satisfaction and factors, such as work control, work stress, workload and organization and professional commitments.

Methods

This study was a cross-sectional design. The survey items were mainly adapted from the US National Pharmacist Workforce Survey. An electronic (Qualtrics) questionnaire was posted on pharmacist social media in several Arab countries. The survey link was posted from 22 March 2021 to 1 May 2021. The multiple linear regression measured the association between 12 independent variables and pharmacist job satisfaction.

Key findings

A total of 2137 usable surveys were received from pharmacists (54.7% female) working in 18 Arabic countries. The job satisfaction rate varied among countries in the Arab world. The fields with the highest satisfaction average included pharmaceutical marketing, academia and the pharmaceutical industry. At the same time, pharmacists working in community pharmacy and Ministry of Health/administrative positions had the lowest satisfaction rates. Overall, pharmacist satisfaction was average (3.1 out of 5). The pharmacists had the lowest satisfaction averages with income and job expectations. The pharmacists with bachelor’s degrees had significantly lower satisfaction than pharmacists with postgraduate degrees. Male pharmacists had significantly higher job satisfaction compared with female pharmacists. Workload and the feelings of organization and professional commitments had significant positive associations with job satisfaction.

Conclusions

The pharmacy profession in Arabic countries faced several challenges that negatively impacted job satisfaction. Improving work environment, professional management, income and organization loyalty is necessary to enhance pharmacist job satisfaction.

Nigerian physiotherapists’ perception of physiotherapy internship: perceived expectations, experience, and outcomes

Background

Physiotherapy internship in Nigeria was inaugurated in 1994 to allow continuous learning in the clinical setting, connecting theoretical knowledge and workplace practice. The internship program has not been evaluated over the years. The aim of study was to assess physiotherapists’ perceptions of the internship in Nigeria in terms of expectations, experiences, and outcomes.

Methods

A mixed method design of a cross-sectional survey and focus group discussion (FGD) was utilized. An adapted questionnaire was used for the survey. Data was assessed using descriptive statistics and content thematic analysis.

Results

The mean age of the physiotherapists who participated in the survey (147 males; 116 females) and FGD (7 males; 2 females) were 27.4 ± 2.5 and 28.8 ± 2.3 years, respectively. Most participants in the survey perceived their internship experience as good (97.7%), the supervision received as adequate (76%), and the outcomes of internship in terms of usefulness as useful (76%). The overall perception of physiotherapy internship in Nigeria was rated as good by 51% and fair by 47% of participants. However, responders in the FGD reported negative experiences including inadequate or lack supervision. They also reported that they were not formally prepared for internship by their training institutions or receiving health institutions before beginning internship.

Conclusion

Physiotherapy internship in Nigeria was perceived as deficient in structural organization and supervision of the interns. The outcome of internship program was perceived as good even though the experiences were negative.

Instruments measuring community pharmacist role stress and strain measures: A systematic review

BACKGROUND

While macro and meso approaches to implementing public health initiatives in community pharmacies have been studied, the micro perspective of their pharmacist providers requires more inspection. Community pharmacists report increasing stress, overload, and limited control over facets of their work.1-7 Social exchange principles, e.g. role price, may help to typify pharmacist work decisions so problematic situations can be modified, thus protecting workforce health. To do so, the underlying pressures of the pharmacist role (i.e. role stresses) and indicators of systemically-caused strain (i.e. role strains) should be measurable.

OBJECTIVES

To summarise validated and reliable instruments used to measure role stress and strain among community pharmacists and evaluate compatibility in testing a theoretically-derived framework.

METHODS

In April 2020, journal articles describing reliable and validated instruments measuring role stress and strain responses among community pharmacists were identified from an online search via Scopus, Web of Science and PubMed. English-language articles after 1990 were selected; duplicates were deleted. Inclusion and exclusion criteria were used to screen title/abstracts and full texts. Reference lists were manually searched. Resultant instruments were analysed for theoretical compatibility.

RESULTS

After review, 26 separate instruments were found: seven psychological strain instruments, 14 social strain response instruments, and five role stress instruments. Role stresses were often present as facet-specific dimensions in psychological and social strain instruments. Strain instruments measuring individual evaluation of work were compatible with a social exchange approach.

CONCLUSIONS

Twenty-six reliable and validated instruments measuring role stress and role strain were found to measure negative role outcomes from the micro community pharmacist perspective. Structural measurement of role stress and resultant negative responses enable detailed examination into pharmacist roles and insights into pharmacist behaviour. Further research is required to develop additional role stress and strain instruments, and to discover pharmacist role benefits and their influence.

A participatory research approach in community pharmacy research: The case for video-reflexive ethnography

Video-reflexive ethnography (VRE) is a qualitative methodology that explores the complex nature of healthcare 'as it really is'. Its collaborative and reflexive process invites stakeholders (e.g. pharmacists and pharmacy support staff) to participate in analysing their everyday work practices as captured on video footage. Through close collaboration with practitioners and attention to their work contexts, VRE may be a useful methodology to engage a time-poor pharmacy workforce in research about themselves, encouraging more practitioner involvement in practice-based research. Aside from research, VRE has also been used effectively as an intervention to facilitate learning and change in healthcare settings, and could be effective in provoking change in otherwise resistant pharmacy environments. Much like traditional ethnographic approaches, VRE researchers have relied on being present 'in the field' to observe, record and make sense of practices with participants. The COVID-19 pandemic however, has introduced restrictions around travel and physical distancing, which has required researchers to contemplate the conduct of VRE 'at a distance', and to imagine new ways in which the methodological 'closeness' to stakeholders and their workplace contexts can be maintained when researchers cannot be on site. In this commentary, we outline the rationale for participatory methods, in the form of VRE, in pharmacy research. We describe the underlying principles of this innovative methodology, and offer examples of how VRE can be used in pharmacy research. Finally, we offer a reflexive account of how we have adapted the method for use in community pharmacy research, to adapt to physical distancing, without sacrificing its methodological principles. This paper offers not only a new methodology to examine the complexity of pharmacy work, but demonstrates also the responsiveness of VRE itself to complexity, and the potential breadth of future research applications in pharmacy both during and beyond the current pandemic.

Connecting a simulated virtual patient program with experiential practicums: Perspectives from year three students

BACKGROUND AND PURPOSE

Research indicates that the simulated learning tools known as virtual patients (VPs) are valued by pharmacy students and impact students' knowledge and confidence. However, research is needed to understand how students can be supported to make intended connections between VP cases and real-life clinical scenarios. The purpose of this study was to examine whether and how VP cases influence students' clinical reasoning skills, confidence, thought processes, and preparedness for their experiential practicums.

EDUCATIONAL ACTIVITY AND SETTING

Third-year entry-to-practice doctor of pharmacy students who had completed at least one VP case in second year prior to their experiential practicums were surveyed in fall 2018 after having completed their experiential practicums. Surveys were structured to solicit student perceptions related to how students bridged VP cases and real-life clinical scenarios and were analyzed using a mixed-methods design.

FINDINGS

Forty-three students completed the survey. Students perceived that VP cases most significantly impacted their clinical reasoning skills due to the opportunity cases afforded them to explore patient data and navigate relevant information. The largest limitation of VP cases to students' learning was that the cases differed from their experiences. Students' suggestions included opportunities for more practice using VP cases and an expanded repertoire of medical conditions offered through case exposure.

SUMMARY

More research is needed to understand how to help students connect VP cases to their experiential practicums to make them more effective learning tools.

Factors affecting community pharmacist work: A scoping review and thematic synthesis using role theory

Many community pharmacists ideologically support recent changes to their roles in primary healthcare. However, their antithetical resistance towards practice change could have systemic causes (i.e. role stresses), which may account for increased job dissatisfaction, burnout, and job turnover in the profession. Deeper comprehension was sought using a role theory framework.

OBJECTIVE

To identify factors leading to role stresses and strain responses for community pharmacists, and to create a framework for community pharmacist role management.

METHOD

PubMed, Scopus and Web of Science databases were searched for qualitative studies identifying community pharmacist role stress and strain using scoping review methodology from 1990 to 2019. Content and thematic analysis using the framework method was performed, and themes were reported using thematic synthesis.

RESULTS

Screening of 10,880 records resulted in 33 studies identified, with 41 factors categorised into four domains: Interpersonal Interactions, Social Setting, Individual Attributes, and Extra-Role. All role stresses were present. Reported role strains suggest role system imbalance.

CONCLUSION

Community pharmacists are in a multifactorial transitional environment. Reported role stresses may be a function of past pharmacist roles and increased role expectations, amplified by many requisite interactions and individual pharmacist characteristics. Social science theories were found to be applicable to the community pharmacy setting.

Community pharmacists at transition to independent practice: Isolated, unsupported, and stressed

While there is evidence from nursing and medicine that transition to independent practitioner is challenging and has implications for patient care, there is little research exploring novice community pharmacists' (NCPs) transition. This study aimed to identify the challenges faced by NCPs at transition to independent practitioner and perceptions of the relative importance of these challenges. Nominal group discussions were held between November 2015 and April 2016, in North West England, with purposively sampled NCPs, early career pharmacists, work-based preregistration tutors, and pharmacy support staff. In response to the question "What are the challenges faced by NCPs at transition?" participants individually wrote down and subsequently called out, in round-robin fashion, then discussed, and broadly categorised challenges before ranking them in order of importance. Discussions were audio-recorded with consent, transcribed, and analysed thematically. Twenty-five participants from independent, supermarket, and small and large multiple pharmacies took part in five nominal group discussions. Challenges experienced through interacting with the workplace environment were identified as: (in order of importance) relationship management; confidence; decision-making; being in charge and accountable; and adapting to the workplace. With the exception of disagreement between pharmacists and pharmacy support staff regarding whether adapting to the team was challenging for NCPs, all participants reported challenges experienced through interacting with the workplace environment. Challenges were described as inducing psychosocial stress, particularly because NCPs acquired immediate professional accountability, worked in isolation from experienced peers, and faced job-related pressures. Interpretation of the findings suggests that the Karasek job-demand-control-support (JDCS) model of occupational stress provides valuable insight about transition for NCPs. NCPs' jobs are classified as high strain, where high workplace demands coupled with NCPs' lack of control in being able to meet demands, together with isolation and lack of support, result in transition being characterised as causing isostrain, where the workplace becomes a "noxious" environment.

Associations between Work Activity and Work Setting Categories and Dimensions of Pharmacists' Quality of Work Life

The goal for this study was to use data from the most recently conducted National Pharmacist Workforce Survey to compare eight components of quality of work life for actively practicing pharmacists in the United States categorized by (1) work activity and (2) work setting. The eight components of quality of work life were: (1) time stress; (2) responsibility stress; (3) level of control; (4) work in harmony with home life; (5) home life in harmony with work; (6) job satisfaction; (7) professional commitment; and (8) organizational commitment. Data for this study were obtained from the 2014 National Pharmacist Workforce Survey. For inclusion in analysis, respondents needed to report that they were practicing as a pharmacist. In addition, they needed to provide usable responses for both their percent time devoted to medication providing and to patient care services. This resulted in a total of 1191 responses for the analysis. Data were analyzed using cluster analysis, factor analysis, Cronbach coefficient alpha, chi-square analysis, ANOVA, and linear regression. The findings provide a description of pharmacists’ quality of work life in 2014 and show how type of work, variety of work, and work setting categories are associated with quality of work life for pharmacists.

The role of community pharmacists in the identification and ongoing management of women at risk for perinatal depression: A qualitative study

BACKGROUND

While pharmacists are among the most accessible primary health professionals within a mother's healthcare team to identify potential cases of perinatal depression (PND), very little in the literature suggests that this role has been explored.

AIM

The aim of this study was to explore community pharmacists' perspectives on their potential roles in perinatal mental health promotion (recognition and health education) and the factors affecting these roles.

METHODS

In total, 20 semi-structured, in-depth interviews were conducted with community pharmacists.

RESULTS

Most pharmacists highlighted their significant roles in recognising PND symptoms and providing medication-related support to perinatal mothers. Barriers to service provision included inter-professional role boundaries, the lack of established referral systems and service remuneration and the lack of adequate training in mental health.

CONCLUSION

Pharmacists could potentially reinforce their involvement in mental health promotion activities.

What can community pharmacy learn from the experiences of transition to practice for novice doctors and nurses? A narrative review

Objectives

In the absence of literature reporting the transition experiences of novice community pharmacists, peer-reviewed evidence on the transition experiences of novice doctors and nurses was identified and reviewed. Specific objectives included identifying the challenges to transition and their perceived impact, before considering the implications for novice community pharmacists.

Methods

The electronic databases MEDLINE, EMBASE, CINAHL, PsycINFO and ScienceDirect were searched for full peer-reviewed original research papers published 1990–March 2015, reporting the transition experiences of novice doctors and nurses. A narrative review following coding of themes was undertaken to synthesise findings with transferability.

Key findings

Twenty-five papers using qualitative and quantitative methods were retrieved from nursing (18) and medicine (6). Challenges were categorised into three themes: personal experiences (where acquiring professional accountability, failing to meet expectations, and emotional, cognitive and physical demands of the job heightened stress), social experiences (where support and acceptance at work were hindered by organisational culture, hierarchy or interpersonal conflict) and challenges from job-related experiences (high workloads, task complexity, staffing, rotations and shift patterns). Challenging transitions were perceived by novice practitioners and their peers as impeding learning, impairing performance and having negative implications for patient care.

Conclusions

While some of these findings may be transferable to community pharmacy settings, contextual differences exist: relative isolation from professional peers, commercially driven private-sector settings, full and immediate acquisition of professional accountability and the lack of clinical career pathways or formalised support. Given these differences, is it appropriate that ‘day-one’ community pharmacists are fully and immediately accountable? Empirical research exploring transition to practice in the community pharmacy setting is needed.

Restructuring supervision and reconfiguration of skill mix in community pharmacy: Classification of perceived safety and risk

BACKGROUND

Broadening the range of services provided through community pharmacy increases workloads for pharmacists that could be alleviated by reconfiguring roles within the pharmacy team.

OBJECTIVES

To examine pharmacists' and pharmacy technicians (PTs)' perceptions of how safe it would be for support staff to undertake a range of pharmacy activities during a pharmacist's absence. Views on supervision, support staff roles, competency and responsibility were also sought.

METHODS

Informed by nominal group discussions, a questionnaire was developed and distributed to a random sample of 1500 pharmacists and 1500 PTs registered in England. Whilst focused on community pharmacy practice, hospital pharmacy respondents were included, as more advanced skill mix models may provide valuable insights. Respondents were asked to rank a list of 22 pharmacy activities in terms of perceived risk and safety of these activities being performed by support staff during a pharmacist's absence. Descriptive and comparative statistic analyses were conducted.

RESULTS

Six-hundred-and-forty-two pharmacists (43.2%) and 854 PTs (57.3%) responded; the majority worked in community pharmacy. Dependent on agreement levels with perceived safety, from community pharmacists and PTs, and hospital pharmacists and PTs, the 22 activities were grouped into 'safe' (n = 7), 'borderline' (n = 9) and 'unsafe' (n = 6). Activities such as assembly and labeling were considered 'safe,' clinical activities were considered 'unsafe.' There were clear differences between pharmacists and PTs, and sectors (community pharmacy vs. hospital). Community pharmacists were most cautious (particularly mobile and portfolio pharmacists) about which activities they felt support staff could safely perform; PTs in both sectors felt significantly more confident performing particularly technical activities than pharmacists.

CONCLUSION

This paper presents novel empirical evidence informing the categorization of pharmacy activities into 'safe,' 'borderline' or 'unsafe.' 'Borderline' activities will deserve particular attention, especially where they are part of processes, e.g. dispensing. This categorization could help inform reconfiguration of skill mix in community pharmacy and thus make an important contribution to the rebalancing medicines legislation agenda and pharmacist supervision.

Patient-centred professionalism in pharmacy: values and behaviours

PURPOSE

Research on patient-centred professionalism in pharmacy is scarce compared with other health professions and in particular with pharmacists early in their careers. The purpose of this paper is to explore patient-centred professionalism in early career pharmacists and to describe reported behaviours. DESIGN/METHODOLOGY/APPROACH - This study explored patient-centred professional values and reported behaviours, taking a qualitative approach. In all, 53 early-career pharmacists, pharmacy tutors and pharmacy support staff, practising in community and hospital pharmacy in England took part; the concept of patient-centred professionalism was explored through focus group interviews and the critical incident technique was used to elicit real-life examples of professionalism in practice.

FINDINGS

Triangulation of the data revealed three constructs of pharmacy patient-centred professionalism: being professionally competent, having ethical values and being a good communicator.

RESEARCH LIMITATIONS/IMPLICATIONS

It is not known whether our participants' perspectives reflect those of all pharmacists in the early stages of their careers. The data provide meaning for the concept of patient-centred professionalism. The work could be extended by developing a framework for wider application. Patient-centred professionalism in pharmacy needs further investigation from the patient perspective.

PRACTICAL IMPLICATIONS

The findings have implications for pharmacy practice and education, particularly around increased interaction with patients.

SOCIAL IMPLICATIONS

The data contribute to a topic of importance to patients and in relation to UK health policy, which allocates more directly clinical roles to pharmacists, which go beyond the dispensing and supply of medicines.

ORIGINALITY/VALUE

The methods included a novel application of the critical incident technique, which generated empirical evidence on a previously under-researched topic.

Making the transition from pharmacy student to pharmacist: Australian interns' perceptions of professional identity formation

OBJECTIVES

The experience of transitioning from university to practice influences professional identity formation. It is unclear how this transitioning experience influences pharmacy interns' professional identities. This study aims to examine pharmacy interns' perceptions of their transition from university to the workplace and the influence this had on their pharmacist identities.

METHODS

A qualitative approach using in-depth interviews was adopted for this study. Fifteen interns (community and hospital) from one school of pharmacy in Australia were interviewed. Questions were asked about the nature of their current intern role, their university experiences, how they saw themselves as pharmacists and their perceptions of the transition to practice.

KEY FINDINGS

The interns interviewed entered the workplace valuing patient-focused aspects of practice and contributing to patient care. The nature of work meant there were limited opportunities to enact these aspects of their professional identities. The interns were challenged by interactions with patients and doctors, and experienced difficulties reconciling this with their university-derived professional identities. Also, the interns lacked the confidence and strategies to overcome these challenges. Some were exploring alternative ways of being pharmacists.

CONCLUSIONS

This paper argues that graduates' experience of the transition to practice was challenging. This was due to nascent professional identities formed in university and a lack of workplace experiences enabling patient-centred practices. The interns' formation of professional identities was highly responsive to the context of work. To facilitate the development of Australian patient-centred pharmacy practice, supporting professional identity formation should be a focus within pharmacy education.

Work experiences of internationally trained pharmacists in Great Britain

OBJECTIVES

Internationally trained health professionals are an important part of the domestic workforce, but little is known about the working experiences of internationally trained pharmacists (ITPs) in Great Britain (GB). The purpose of this study is to explore the work experiences of ITPs practising in the community or hospital sector in GB.

METHODS

Twenty-five semi-structured, face-to-face interviews were conducted with a sample of European Economic Area (EEA) and non-EEA pharmacists who, at the time of the study, practised in the community (n = 20) or hospital sector (n = 5) in the North West England from March to May 2009.

KEY FINDINGS

In general, ITPs complained about their heavy workload, long working hours and lack of support from their employers. Specifically, EEA pharmacists in most cases felt excluded from the professional network and sensed colleagues saw them as 'foreigners' while some non-EEA pharmacists had to deal with a level of hostility from patients.

CONCLUSIONS

This novel research provides a foundation for future work on ITPs in GB and could assist employers to better target their efforts in development of standards to support the working experiences of ITPs in GB.

Community pharmacies automation: any impact on counselling duration and job satisfaction?

BACKGROUND

One key indicator of the quality of health practitioners-patient interaction is the encounters' duration. Automation have been presented as beneficial to pharmacy staff work with patients and thus with a potential impact on pharmacists' and technicians' job satisfaction.

OBJECTIVE

To compare the interaction length between pharmacy staff and patients, as well as their job satisfaction, in community pharmacies with and without automation.

SETTING

Portuguese community pharmacies with and without automation.

METHODS

This cross-sectional study followed a quasi-experimental design, divided in two phases. In the first, paired community pharmacies with and without automation were purposively selected for a non-participant overt observation. The second phase comprised a job satisfaction questionnaire of both pharmacists and technical staff. Practitioners and patients demographic and interactional data, as well as job satisfaction, were statistically compared across automation.

MAIN OUTCOME MEASURE

Interaction length and job satisfaction.

RESULTS

Sixty-eight practitioners from 10 automated and non-automated pharmacies produced 721 registered interaction episodes. Automation had no significant influence in interaction duration, controlling for gender and professional categories, being significantly longer with older patients (p = 0.017). On average, staff working at the pharmacy counter had 45 % of free time from direct patient contact. The mean overall satisfaction in this sample was 5.52 (SD = 0.98) out of a maximum score of seven, with no significant differences with automation as well as between professional categories, only with a significant lower job satisfaction for younger pharmacists.

CONCLUSION

As with previous studies in other settings, duration of the interactions was not influenced by pharmacy automation, as well as practitioners' job satisfaction, while practitioners' time constrains seem to be a subjective perception.

Changes to supervision in community pharmacy: pharmacist and pharmacy support staff views

Pharmacists now offer increasing levels and ranges of clinical, diagnostic and public health services, which may require a pharmacist to be absent from the pharmacy premises. Currently, in the UK, many pharmacy activities legally require the direct supervision and physical presence of the pharmacist. This study aimed to explore the potential for changes to supervision, allowing pharmacist absence, and greater utilisation of pharmacy support staff. Four nominal group discussions were conducted in May 2012 with community pharmacists (CPs), community pharmacy support staff, hospital pharmacists and hospital pharmacy support staff, involving 21 participants. Participants were asked to generate pharmacy activities, which they felt could/could not be safely performed by support staff in the absence of a pharmacist, followed by a discussion of these items and voting using an agreement scale. A written record of the items generated and voting scores was made and the group discussion elements were audio-recorded, transcribed verbatim and analysed thematically. The selling of general sales list medicines, assembly of prescriptions and provision of public health services received a high level of agreement between groups, as activities that could be performed. There was greater disagreement about the safety of support staff selling pharmacy medicines and handing out checked and bagged prescription items to patients. Group discussion revealed some of the main challenges to supervision changes, including CPs' perceptions about their presence being critical to patient safety, reluctance to relinquish control, concerns about knowing and trusting the competencies of support staff, and reluctance by support staff to take greater professional responsibility. The findings of this study aim to inform a future consultation on changes to pharmacy supervision in the UK. The empowerment of pharmacy technicians as a professional group may be key to any future change; this may require clarity of their professional responsibilities, enhanced career progression and appropriate remuneration to match greater responsibility.

The association of subjective workload dimensions on quality of care and pharmacist quality of work life

BACKGROUND

Workload has been described both objectively (e.g., number of prescriptions dispensed per pharmacist) as well as subjectively (e.g., pharmacist's perception of busyness). These approaches might be missing important characteristics of pharmacist workload that have not been previously identified and measured.

OBJECTIVES

To measure the association of community pharmacists' workload perceptions at three levels (organization, job, and task) with job satisfaction, burnout, and perceived performance of two tasks in the medication dispensing process.

METHODS

A secondary data analysis was performed using cross-sectional survey data collected from Wisconsin (US) community pharmacists. Organization-related workload was measured as staffing adequacy; job-related workload was measured as general and specific job demands; task-related workload was measured as internal and external mental demands. Pharmacists' perceived task performance was assessed for patient profile review and patient consultation. The survey was administered to a random sample of 500 pharmacists who were asked to opt in if they were a community pharmacist. Descriptive statistics and correlations of study variables were determined. Two structural equation models were estimated to examine relationships between the study variables and perceived task performance.

RESULTS

From the 224 eligible community pharmacists that agreed to participate, 165 (73.7%) usable surveys were completed and returned. Job satisfaction and job-related monitoring demands had direct positive associations with both dispensing tasks. External task demands were negatively related to perceived patient consultation performance. Indirect effects on both tasks were primarily mediated through job satisfaction, which was positively related to staffing adequacy and cognitive job demands and negatively related to volume job demands. External task demands had an additional indirect effect on perceived patient consultation performance, as it was associated with lower levels of job satisfaction and higher levels of burnout.

IMPLICATIONS/CONCLUSIONS

Allowing community pharmacists to concentrate on tasks and limiting interruptions while performing these tasks are important factors in improving quality of patient care and pharmacist work life. The results have implications for strategies to improve patient safety and pharmacist performance.

British pharmacists' work-life balance – is it a problem?

Objectives

Using a validated tool, the study aimed to explore pharmacists' experiences of maintaining work/life balance in a large, nationally representative sample of pharmacists in Great Britain (GB).

Methods

A two-page postal questionnaire was sent in 2008 to all GB-domiciled pharmacists who were registered with the regulatory body for pharmacy in GB (just over 44 000 pharmacists). Demographic information, work patterns and other employment data were collected and analysed using regression techniques to explore the link between these characteristics and a validated measure of work/life balance.

Key findings

The response rate to the census was 69.6% (n = 30 517). Eighty-three per cent (n = 25 243) of respondents were working as a pharmacist and were therefore eligible to complete the work/life balance statements. The results reported here relate to 12 364 individuals who had full data for the work/life balance scale and the demographic and work variables. Findings indicate that age, ethnicity, having caring responsibilities, sector of practice, hours of work and type of job are significant predictors of work/life balance problems.

Conclusions

Pharmacy employers and government should recognise the changing demographic characteristics of the profession and consider what support might be available to the workforce to help alleviate work/life balance problems being experienced by certain groups of pharmacists.

Why do Australian registered pharmacists leave the profession? a qualitative study

BACKGROUND

Understanding why people choose to leave their professions is important to inform workforce planning to meet community needs. Poor job satisfaction has been linked to health practitioners expressing intentions to leave in other professions such as nursing, occupational therapy and medicine, but little is known about the reasons why pharmacists leave their profession.

OBJECTIVE

To explore reasons why Australian pharmacists leave the profession.

SETTING

As part of a survey of the Australian pharmacist workforce, a questionnaire was mailed to all registered pharmacists (n = 7,764) on the registers of the Pharmacy Boards of Victoria and South Australia; 1,627 (21 %) responded. Participants, who were registered but no longer working as a pharmacist, were asked to provide contact details if they were willing to be interviewed for this study; 89 (5.5 %) pharmacists accepted an invitation. A proportionate sample of 20 was selected for the interview.

METHOD

A semi-structured interview schedule was developed with probe options which encouraged participants to further explore their responses to questions. De-identified audio records of interviews were transcribed verbatim and thematically analysed.

MAIN OUTCOME MEASURE

Reasons why pharmacists leave the pharmacy profession.

RESULTS

Five themes emerged: (1) Dissatisfaction with the professional environment; (2) lack of career paths and opportunities; (3) under-utilisation of pharmacists' knowledge and skills; (4) wanting a change; and (5) staying connected with pharmacy.

CONCLUSION

These findings provide insights to the pharmacy sector, previously unexplored in Australia, and informs future pharmacist workforce planning. To retain experienced, mid-career pharmacists in the profession, strategies to increase opportunities for career progression, better use of pharmacists' knowledge and skills and involvement in patient care are required to increase job satisfaction and improve retention rates.

How to enhance public health service utilization in community pharmacy?: general public and health providers' perspectives

BACKGROUND

Community pharmacists (PHs) in England are increasingly providing a range of public health services. However, the general public view pharmacists as drug experts and not experts in health, and therefore, services may be underutilized.

OBJECTIVES

To explore experiences and views of 4 groups of participants, the general public, PHs, general practitioners (GPs), and other stakeholders (STs) on pharmacy-based public health services, and identify potential factors affecting service use.

METHODS

The study was undertaken in a locality of North West England. Three focus groups were conducted with the general public (n=16), grouped by socioeconomic status. Fourteen semistructured interviews were undertaken with PHs (n=9), GPs (n=2), and STs (n=3). Discussions/interviews were audio recorded, transcribed verbatim, and analyzed thematically.

RESULTS

All 4 groups of participants agreed that community pharmacies are a good source of advice on medicines and minor ailments but were less supportive of public health services. Six factors were identified affecting utilization of pharmacy services: community pharmacy environment, pharmacist and support staff, service publicity, general public, GP services, and health care system and policies. Crucial obstacles that could inhibit service utilization are perceptions of both the general public and other health providers toward pharmacists' competencies, privacy and confidentiality in pharmacies, high dispensing workload, and inadequate financial support. Networking between local health professionals could enhance confidence in service delivery, general awareness, and thus utilization.

CONCLUSIONS

Community pharmacy has the potential to deliver public health services, although the impact on public health may be limited. Addressing the factors identified could help to increase utilization and impact of pharmacy public health services.

Smoking cessation counseling in Qatar: community pharmacists' attitudes, role perceptions and practices

BACKGROUND

Smoking is a major public health problem in Qatar. The potential for community pharmacists to offer smoking cessation counseling in this country can be high.

OBJECTIVES

To determine the current smoking cessation practices of community pharmacists in Qatar, to examine their attitudes about tobacco use and smoking cessation, to evaluate their perceptions about performing professional roles with respect to smoking cessation and to assess their perceived barriers for smoking cessation counseling in the pharmacy setting in Qatar.

SETTING

Community pharmacies in Qatar.

METHODS

The objectives were addressed in a cross sectional survey of community pharmacists in Qatar from June 2010 to October 2010. A phone call was made to all community pharmacists in Qatar (318 pharmacists) inviting them to participate. Consenting pharmacists anonymously completed the survey either online or as paper using fax. Data was analyzed using Statistical Package of Social Sciences (SPSS®) Version 18.

MAIN OUTCOME MEASURES

Qatar community pharmacists' smoking cessation practices, their attitudes toward tobacco use, smoking cessation and smoking cessation counseling and their perceived barriers for smoking cessation counseling.

RESULTS

Over 5 months, we collected 127 surveys (40 % response rate). Only 21 % of respondents reported that they always or most of the time asked their patients if they smoke. When the patients' smoking status was identified, advising quitting and assessing readiness to quit were always or most of the time performed by 66 and 52 % of respondents respectively. Only 15 % always or most of the time arranged follow-up with smokers and 22 % always or most of the time made smoking cessation referrals. Most respondents (>80 %) agreed that smoking could cause adverse health effects and that smoking cessation could decrease the risk of these effects. In addition, the majority (>80 %) believed that smoking cessation counseling was an important activity and was an efficient use of their time. The top two perceived barriers for smoking cessation counseling were lack of time (65 % of respondents) and lack of patients' interest in smoking cessation (54 %).

CONCLUSIONS

Qatar community pharmacists have positive attitudes toward smoking cessation counseling. These attitudes need to be translated into action. Interventions should be implemented to overcome perceived barriers and to improve smoking cessation activities among pharmacists.

Workload and its impact on community pharmacists' job satisfaction and stress: a review of the literature

Objective

The objective was to identify, review and evaluate published literature on workloads of pharmacists in community pharmacy. It included identification of research involving the measurement of pharmacist workload and its impact on stress levels and job satisfaction. The review focused on literature relating to practice in the UK.

Methods

Electronic databases were searched from 1995 to May 2011. In addition, manual searches were completed for documents not available electronically. The findings were analysed with specific focus on research methodology, workload and its impact on pharmacist job satisfaction and stress levels.

Key findings

Thirteen relevant studies relating to workload in community pharmacy alone or in conjunction with job satisfaction and stress were identified. One utilised both qualitative and quantitative methods to identify differences in pharmacist workload in retail pharmacy businesses before and after the implementation of the 2005 English and Welsh community pharmacy contractual framework. This indicated that pharmacists spend most of their working day dispensing. The majority of studies suggested community pharmacists generally perceived that workload levels were increasing. Several also stated that increased workload contributed to increasing job-related stress and decreasing job satisfaction. No studies reporting dispensing rates for community pharmacies in the UK were identified and there was limited evidence concerning time devoted to non-dispensing services. One study investigated the differences between self-estimated and actual workload.

Conclusions

Whilst there is a clear perception that the type and amount of work output expected from individual community pharmacists has been changing and increasing over the last few decades, pharmacists are viewed as continuing to remain based in the dispensary. The impact of such changes to the practice of community pharmacy in the UK is poorly defined, although links have been made to increasing levels of pharmacist job dissatisfaction and stress.

Interpersonal interactions, job demands and work-related outcomes in pharmacy

Objectives

The objective of this study was to examine the interaction between job demands of pharmacists and resources in the form of interpersonal interactions and its association with work-related outcomes such as organizational and professional commitment, job burnout, professional identity and job satisfaction. The job demands-resources (JD-R) model served as the theoretical framework.

Methods

Subjects for the study were drawn from the Pharmacy Manpower Project Database (n = 1874). A 14-page mail-in survey measured hospital pharmacists' responses on the frequency of occurrence of various job-related scenarios as well as work-related outcomes. The study design was a 2 × 2 factorial design. Responses were collected on a Likert scale. Descriptive statistics, reliability analyses and correlational and multiple regression analyses were conducted using SPSS version 17 (SPSS, Chicago, IL, USA).

Key findings

The 566 pharmacists (30% response rate) who responded to the survey indicated that high-demand/pleasant encounters and low-demand/pleasant encounters occurred more frequently in the workplace. The strongest correlations were found between high-demand/unpleasant encounters and frequency and intensity of emotional exhaustion. Multiple regression analyses indicated that when controlling for demographic factors high-demand/unpleasant encounters were negatively related to affective organizational commitment and positively related to frequency and intensity of emotional exhaustion. Low-demand/pleasant encounters were positively related to frequency and intensity of personal accomplishment. Low-demand/unpleasant encounters were significantly and negatively related to professional commitment, job satisfaction and frequency and intensity of emotional exhaustion, while high-demand/pleasant encounters were also related to frequency and intensity of emotional exhaustion

Conclusion

Support was found for the JD-R model and the proposed interaction effects. Study results suggest that adequate attention must be paid to the interplay between demands on the job and interactions with healthcare professionals to improve the quality of the pharmacist's work life. Future research should examine other types of job demands and resources.

Workload in community pharmacies in the UK and its impact on patient safety and pharmacists' well-being: a review of the evidence

New contractual frameworks for community pharmacy are believed to have increased workload for pharmacists; too much work has been implicated in high profile cases of dispensing errors leading to patient harm, and concerns about pharmacists' well-being. A review was undertaken to ascertain whether community pharmacists' workload has increased and whether links between workload and patient safety and pharmacists' well-being have been established. We searched Scopus; EMBASE; MEDLINE; PubMed; CINAHL; PsychINFO; ASSIA; E-pic, and International Pharmaceutical Abstracts for research published between 1989 and 2010 containing data on UK community pharmacy workload, and on its consequences when workload was found to be a determinant of either patient or pharmacist outcomes. Researchers assessed retrieved material against inclusion and exclusion criteria and synthesised findings using a data extraction form. Fifteen studies were retrieved that met the inclusion criteria. A number of methodological weaknesses were identified: studies categorised work tasks and workload differently making comparisons over time or between studies difficult; most studies were small scale or conducted in specific localities, or lacked sufficient methodological information to rule out bias; studies that control for possible confounders are rare. The reviewed research suggests that community pharmacists still spend the majority of their time involved in activities associated with the dispensing of prescriptions. There is some evidence that community pharmacists' workload has increased since the introduction of the new contracts in England and Wales, especially around the core activity of dispensing prescriptions and medicines use reviews. There is also some evidence to suggest a link between heavy workload and aspects of pharmacists' well-being but there is no robust evidence indicating threats to patient safety caused by their having too much work to do. More high quality research is required to examine what constitutes too much work, the impact of high workload, and associations with other work place factors.

Factors influencing pharmacist performance: a review of the peer-reviewed literature

OBJECTIVES

To undertake a review of peer-reviewed literature to explore factors affecting pharmacists' performance.

METHODS

The following databases were searched: Medline, Embase, Scopus, ISI Web of Knowledge and PsychInfo. Inclusion criteria were: English language only, published between 1990 and 2010 and published in the United Kingdom (UK), United States of America (USA), Canada, Australia, New Zealand or Europe.

RESULTS

The search strategy identified 37 items. The review found that there was some evidence to suggest that pharmacists with certain characteristics (e.g. being male, being of ethnic minority origin, working in community pharmacy and having trained overseas) were more likely to experience performance problems. Factors relating to workload and work environment were associated with performance problems, particularly in relation to errors. There was some limited evidence to suggest that experiencing problems with alcohol or drugs could negatively impact on pharmacists' performance.

CONCLUSION

The findings suggest that pharmacist performance may be affected by multiple factors, including personal characteristics such as age, gender, ethnicity, place of primary qualification, factors associated with the workplace and mental and physical health problems. The evidence is not unequivocal and gaps in the literature exist, suggesting that pharmacist performance is an under-researched area.

Breast cancer health promotion in Qatar: a survey of community pharmacists' interests and needs

OBJECTIVES

Breast cancer is the most common cancer in women in Qatar. Despite the sustained efforts to increase breast cancer public awareness via campaigns and public screening programmes, breast cancer screening rate remains low. The involvement of community pharmacists in the communication and distribution of breast cancer screening information should have a significant positive impact. The objectives of this study were to determine the degree of community pharmacists' involvement in breast cancer health promotion activities in Qatar, to explore their attitudes towards the involvement in breast cancer health promotion, to assess their breast cancer knowledge, to gauge their interest in receiving breast cancer continuous education and to list their perceived barriers for including breast cancer health promotion activities into their daily practice.

SETTING

Community pharmacies in Qatar.

METHOD

The study objectives were addressed in a cross-sectional survey of all community pharmacists in Qatar.

MAIN OUTCOME MEASURES

The extent of community pharmacists' involvement in breast cancer health promotion activities, the community pharmacists' interest and comfort in providing breast cancer health promotion, their breast cancer knowledge, their interest in receiving breast cancer continuous education, their attitudes and beliefs towards breast cancer health promotion and their perceived barriers for integrating breast cancer heath promotion activities into their daily practice.

RESULTS

Over a 12-week period, we collected 195 surveys (60% response rate). Eighty-eight percent indicated that they never invited healthcare professionals to provide breast cancer education in the pharmacy, 78% said that they never distributed breast cancer educational materials, and 58% reported that they never counseled patients about breast cancer. Nevertheless, more than 60% were highly interested in being engaged in breast cancer health promotion activities. In addition, 87% believed that discussing breast cancer awareness with female patients in the pharmacy was beneficial to patients. Yet pharmacists perceived many barriers for integrating breast cancer health promotion into their daily practice including lack of educational materials (79%) and lack of public recognition (61%). Moreover, their breast cancer knowledge mean score was 63% with 77% expressing a high interest in receiving breast cancer continuous education.

CONCLUSION

Despite their low involvement in breast cancer health promotion, the majority of pharmacists were interested in educating patients about breast cancer. However, low breast cancer knowledge and other barriers can prevent actualizing this role. Further work should focus on providing these pharmacists with breast cancer continuous education and overcoming all stated barriers.