Perception of Maharashtra Community Pharmacists Towards Patient Counseling and Continuing Pharmacy Education Program: A Multicentric Study

ABSTRACT O !ecti"e: To study the perception of community pharmacists towards patient counseling and continuing pharmacy education programs. Methods: A semi structured questionnaire was developed & research was carried out in three major cities in Maharashtra Namely Mumbai, une & Nashi!. The filled questionnaires were analy"ed as per the study objectives. Results: Altogether, #$ community pharmacists were included. Among them, %%.##& were male. More than '( patients visit most of the community pharmacies )%$& *n + #,-. daily. Most of the dispensers )/%& *n + ,'-. too! 01' minutes for dispensing a prescription. 2n most of the pharmacies )/,& *n + ,#-., only 0 dispensers 3 pharmacist & the qualification of a majority of dispensers were 41 harm. Most of them )5/./'& *n + 5/. believed that counseling was necessary as it was their own duty, but however, ),/.(%& *n + 0,- said that it was necessary to increase sales. 6ur finding suggests that %#.##& of retailers were facing some problems during patient counseling. Most of the participants were interested in the continuing pharmacy education program. Conclusion: 6n the whole, the community pharmacists had a positive response towards patient counseling. 6ur findings suggest the need for continuing pharmacy education programs in Maharashtra to strengthen the concept of patient counseling.

#ntroduction 7ou may !now little about the wor!ing environment of your colleagues in community practice. The community pharmacist has an increasingly wide role as a healthcare professional. Apart from the obvious activities of dispensing prescriptions and selling over the counter *6T8- medicines, community pharmacists also carry out such functions as 9 responding to patients: symptoms 9 diagnostic services such as pregnancy testing, blood pressure measurement, and testing of blood fluids 9 health promotion 9 wor!ing with general medical practitioners on prescribing issues and formulary and clinical guideline development. 9 advisory services to local care homes 9 needle e;change supply for drug misusers 9 supply of methadone or buprenorphine to drug misusers This guide aims to help you to ma!e the most of your secondment to a

community pharmacy. 7ou need to be disciplined in this time to get an understanding of how community pharmacists wor!. 4epending on your previous e;periences *eg vacational employment in a pharmacy- you may decide that you want to e;perience certain areas of the pharmacy practice more than others so the boo!let is divided into sections. These reflect the main areas of community pharmacy practice. The various tas!s and questions may be used as performance evidence and have been cross1referenced to the <nits of the = >?@ erformance >tandards. 2n Appendi; # there is a form to summarise the activities completed during your secondment. 4uring the placement, you should also aim to develop further personal learning objectives. Aor e;ample, you may see and e;perience things in community pharmacy which ma!e you as! more about various aspects of hospital practice, but you may need to wait until you return to your hospital before those questions can be answered. 7ou may loo! at prescriptions for conditions that you are not so familiar with wor!ing in a hospital setting and you may want to learn more about such conditions. Bvery community pharmacy is different1 in si"e, layout, numbers and grades of staff, clientele, services provided and merchandise sold. Cowever, whatever sort of community pharmacy you visit, you will learn much about the practice environment, which has differences from 1 but also similarities to 1 your own. 7our comments on this pac! will be valuable and allow the materials to be amended or updated. lease ta!e five minutes to complete the form *found at the bac! of this *boo!let- and return it to your tutor or the re1registration 4ivision,

$%th century #ndian Pharmacy

&$st Century #ndian Pharmacy

The advantages
are a great pay, you are surrounded by lots of very intelligent people, and with a Pharm. D. Degree which has replaced the Bachelor of Pharmacy Degree helps you get a great job in a lot of places. the disadvantages are there's a lot of work hrs., you are in school from 4 to yrs, and there's a lot of time away from your family

O !ecti"es At the end of your time in the community pharmacy you should be able toD 9 2dentify the different types of staff within the pharmacy and outline their roles and responsibilities 9 4escribe how the community pharmaceutical service is organised and funded 9 6utline the roles of !ey healthcare professionals within the primary care >etting 2n a community pharmacy, there will always be a pharmacist present and a number of other support staff, which could include one or more dispensary staff and medicines counter assistants. Cowever, community pharmacists are increasingly wor!ing with other healthcare professionals, and it is therefore important that you find out about them and their roles.

Materials and Methods A semi1structured questionnaire was formulated by the researcher *Appendi; E 0*Table3fig 0 - as per the study objectives.

Questionnaire to evaluate the perceptions of the community pharmacists towards patient counseling and continuing pharmacy education !. "hat is the #ualification of the owner of your pharmacy$ % D. Pharm % B. Pharm % &rientation % &ther 'ualification (. "hat is the total number of pharmacists in your pharmacy % )! % (*+ % +*!) % more than !) ,. "hat is the basic #ualification of the employees in your pharmacy$ -umber of pharmacists -umber of pharmacists % D. Pharm......../ % B. Pharm......./ % &rientation......./ % &ther 'ualification0...../ 4. "hat is the working hours of your pharmacy 1111111111111111111111111111111111111

+. &n an average how many people come to your pharmacy in a day$ % !) to () % () to (+ % ,+ to +) % more than +) . &2 an average how much time do you take to dispense a prescription$ % 3ess than lminute % ! to + minutes % + to !) minutes % more 4. Do you think a pharmacist is re#uired in a pharmacy % 5es % -o "hy$ 111111111111111111111111111111111111 6. Do you think you get professional respect from the public$ % 5es % -o 7. "hat are the reference books available in your pharmacy$ %........................ % ................................ %......................... % ................................. !). Do you dispense 8chedule Drugs on prescriptions only$ % 5es % -o !!. "hich type of &9: drugs do you dispense most commonly$ % 3o;enges % antihistaminic<antiallergic % =nalgesics % &thers !(. Do you give advice to your patients regarding medicines$ % 5es % -o

!,. Do you think giving advice to the patients is important$ "hy$ % 5es % -o >f yes %9o improve compliance % Duty %9o have professional satisfaction % 9o improve sales % 8trategy to overcome competition % &thers................ !4. "hat do you talk to the patients regarding medicines$ % Dose % Duration % =dministration time % 8torage aspects % 8ide ?ffects % &thers !+. =re the patients interested in knowing about their medicines$ % 5es % -o ! . "hat #uestions does the patient usually ask$ % Dose % Duration % =dministration time % 8torage aspects % 8ide ?ffects % :ost % Diseases % &thers !4. =re you interested in counseling the patients$ % 5es % -o !6. "hat do you think are the problems in counseling the patients$ F 3ack of time % 3ack of knowledge F 3ack of interest of the patients % &thers !7. 2ow can you overcome these problems$ % By increasing the number of pharmacists % By providing separate space for counseling % By procuring ade#uate books % By providing e@tra money for counseling % By attending :ontinuing ?ducation Programs % &thers............................... (). Do you think :ontinuing ?ducation Programs are helpful in improving your knowledge about medicines$ % 5es % -o (!. =re you interested in attending :ontinuing ?ducation Programs$

% 5es

% -o

((. >f you are interested what areas are you interested to learn more$ % :ommon Diseases % :ommon Drugs % 3ifestyles % &thers.

RES'(TS Altogether, #$ community pharmacists were included in this study. Among them *n +#'were males & *n + ,- were females. Numbers of patients visiting community pharmacists *n + #$Bveryday, more than '( patients visited %$& *n + #,- of the community pharmacies followed by #' E '( patients *'& *n + ,--, ,( E ,' patients *'& *n + ,- - & 0( 1,( patients *#& *n+0- - to fill their prescription. 4ispensing time in community pharmacies *n+#$More than half */%& *n + ,'-- of the dispensers too! 01' minutes for dispensing a prescription, followed by '10( minutes *,,& *n + %--. Aive percentage, *n+,- of them too! more than 0, minutes& '& of them too! less than 0 minute, in most of the pharmacies */,& *n + ,#--, there was only 0 dispensers, followed by ,1' dispensers in #'& *n+0#- of pharmacies & only #& *n+0- of pharmacies had more than ' dispensers. Gualification of the owners of community pharmacies *n + #$The qualifications of the owners of the pharmacies were 4. harm & *'%& *n + ,0-followed by @. harm & other qualifications each of ,,& *n + %Gualification of dispensers of community pharmacies *n + As li!e the Gualification of the owners of the pharmacies of a majority of dispensers were 4. harm *$/& *n + /--. Bight percentage *n + #- of the dispensers were of other qualifications. 8ommon sources of drug information available in the community pharmacies *n + /,The commonest sources of drug information were, the current inde; of medical specialties *ums-, a commonly used drug inde; of 2ndian origin *'%.(/& *n + #/-, followed by drug today *,5.0H& *n + 0'-- & Monthly inde; of medical specialties *M2M>*00.,H& *n + $-- & also 2ndian drug review *24=- */.5'& *n + 5-The purpose of giving medication counseling *n + /(There are different feelings among the majority *5'1/'& *n + 5/-- of them considered counseling as their duty. The views e;pressed by them regarding the purpose of counseling vacy. roblem faced during patients counseling *n + #$Aifty nine percent *n + ,,- of community pharmacists felt that each of time was the major problem or barrier faced during patients counseling, followed by lac! of patient interest

,%& *n + 0(- & lac! of !nowledge 0/& *n + /- fourteen percent *n + '- of them felt that they had other problems. >trategies suggested by dispensers to overcome the barriers *n + #$The vacious strategies suggested by the dispensers to overcome the e;perienced barriers, are given in table 0. >trategies suggested by dispensers to overcome the barriers Strategies 2ncreasing the no of pharmacists roviding separate area for counseling @y providing adequate boo!s @y charging e;tra money for counseling @y attending 8 B programs 6thers )um er $ 0( $ ( / 0# Percentage 0H& ,%& 0H& (& 0/& #'&

Arequently as!ed questions by the patients *n + #$atients as!ed several questions to the pharmacists while counseling. The details on frequently as!ed questions are given in table ,. Arequently as!ed questions by the patients *n + #$Sr * )o 0 , # 5 ' / $ % +re,uently as-ed ,uestions y the patients 8ost Administration time 4ose >ide effects >torage aspects 4isease 4uration of therapy 6thers )um ers 0% 0# 0/ 00 $ 0H ' ( Percentage 5%& #'& 5#& #(& 0H& '0& 0#& (&

The dispensers interest in the 8 B program *n + #$All the participants community pharmacists or respondents were entrusted in the continuing pharmacy education *8 B- program & all of them felt that continuing

pharmacy education program would help in improving their !nowledge furthermore, more number of dispensers were interested in the 8 B programmes on common drugs *'H&* n+,,--, followed the 8 B program on diseases *'$& *n + ,0--, the 8 B rogram on lifestyle *,5& *n + H-- & others *00& * n+ 5-- .