Qadeer Gohar, Amin Mohamed Ezzat Khamis
College of Pharmacy, Natural and Health Sciences, Manchester University, Fort Wayne, Indiana, USA.
Beirut Arab University Faculty of Pharmacy, Beirut, Lebanon.
J Eval Clin Pract. 2021 Feb;27(1):151-157. doi: 10.1111/jep.13405. Epub 2020 Apr 22.
RATIONALE, AIMS, AND OBJECTIVES: Little attention has been given to perceptions of pharmacist availability and role in the community setting following policy changes. The Pakistani model is particularly interesting as it encompasses three different pharmacy practice licensure types with major differences in credentials, training, and role. Guided by the theory of planned behaviour (TPB), this study examined factors associated with the availability of pharmacists in the community setting in Pakistan following the implementation of a new policy regulating pharmacist presence in community pharmacies.
Fifteen participants were interviewed in three Pakistani cities (Islamabad, Lahore, and Peshawar). Those included pharmacy licence holders (types A, B, and C), non-pharmacist owners and a pharmacist inspector who were purposively sampled to assure variance in education, gender, time in practice, and geographic location. Directed content analysis was performed based on the TPB framework. Description of themes came after discussions among the two authors.
Findings indicated a discrepancy between participants about the value of having a pharmacist present with pharmacists showing more appreciation of the value they would provide. Participants felt that the new policy is attempting to change a norm that has existed for a long time. They also pointed to logistical challenges in making a pharmacist available including the feasibility of having a pharmacist present, the financial burden of hiring a pharmacist, and difficulty in enforcing the law uniformly across different geographical areas. Participants were concerned that some type A licence holders sensed that practicing in the community setting and the act of selling medications was beneath their social status as pharmacists.
A set of factors contribute to the availability of pharmacists in community pharmacies in Pakistan. The change in law should be supplemented with other interventions that contribute to making well-trained pharmacy personnel available for serving patrons.
原理、目的和目标：政策变化后，社区环境中对药剂师可及性及其作用的认知很少受到关注。巴基斯坦模式尤其有趣，因为它包含三种不同类型的药房执业许可，在资质、培训和职责方面存在重大差异。本研究以计划行为理论（TPB）为指导，调查了巴基斯坦实施一项规范社区药房药剂师在岗情况的新政策后，与社区环境中药剂师可及性相关的因素。
在巴基斯坦的三个城市（伊斯兰堡、拉合尔和白沙瓦）对15名参与者进行了访谈。这些参与者包括药房执照持有者（A、B和C类）、非药剂师所有者以及一名药剂师检查员，他们是经过有目的抽样选取的，以确保在教育程度、性别、执业时间和地理位置方面存在差异。基于TPB框架进行了定向内容分析。两位作者在讨论后对主题进行了描述。
研究结果表明，参与者在药剂师在岗的价值方面存在分歧，药剂师对自身能提供的价值更为认同。参与者认为新政策试图改变长期以来存在的一种常态。他们还指出，让药剂师在岗存在后勤方面的挑战，包括药剂师在岗的可行性、雇佣药剂师的经济负担以及在不同地理区域统一执法的困难。参与者担心一些A类执照持有者认为在社区环境中执业以及售药行为有失其药剂师的社会地位。
一系列因素影响着巴基斯坦社区药房药剂师的可及性。法律变革应辅以其他干预措施，以促使训练有素的药房工作人员能够为顾客服务。
