Opinion comparison concerning future information technology in Finnish community pharmacies

Objective To compare the opinions of community pharmacy owners, managers and personnel concerning the key features of the future information technology system needed in Finnish community pharmacies. Setting The study was targeted to the pharmacists working in community pharmacies as managers (owners and staff pharmacists with M.Sc. degree) or personnel responsible for dispensing and patient counselling (pharmacists with B.Sc. degree). Method A national cross-sectional survey to all of Finnish community pharmacy owners (n = 580) and staff pharmacists (B.Sc. and M.Sc. degrees, n = 1709) working in community pharmacies, was conducted in order to determine differences in opinions between these occupation groups with different professional duties. The response rates were 53% for pharmacy owners (n = 308) and 22% for staff pharmacists (n = 373). Main outcome measure The main outcome measure was the perceived importance of 89 potential features for a new IT system ranked by using a five-point Likert scale. Results The responding community pharmacy managers and staff pharmacists had differences in their ranking of more than half (52%) of the potential features listed in the survey questionnaire. The features related to the pharmacy’s internal processes, such as financial management, sales and marketing management and stock holding, were ranked significantly higher by the managers, while the personnel prioritized the features supporting pharmaceutical service provision and personnel management. The managers and personnel shared their opinion on the importance of features supporting drug information and patient counselling, medication safety and interprofessional collaboration. Conclusion The managers and staff pharmacists have different views of the importance of IT features, reflecting their different professional duties in the community pharmacy. A high priority was given for the features familiar to the users and needed in their daily practice. This indicates the need for involving different occupation groups in planning the new IT systems for community pharmacies.     

Views, attitudes and self-assessed training needs of Scottish community pharmacists to public health practice and competence

Objective To assess the education and training needs of community pharmacists to support the delivery of an expanded public health role. Setting Community pharmacy in Scotland. Method Two focus groups of community pharmacists (n = 4 in each) in geographically distinct regions of Scotland explored issues of public health function, competencies and education and training. Findings from thematic analysis were used to develop a draft postal questionnaire. Following piloting, pharmacist managers from a random sample of 500 community pharmacies in Scotland were contacted by telephone to ascertain the number of pharmacists working in each pharmacy in the following 14-day period. A survey pack containing questionnaires for each identified pharmacist working in the study period was sent by post to the pharmacist manager in each pharmacy. The questionnaire contained items on: demographics; views and attitudes towards: public health; competencies for public health practitioners; and education and training needs. One postal reminder was sent 2 weeks later. Main Outcome Measures Main themes identified from focus group discussions; questionnaire response rate; views and attitudes towards public health competencies and education and training. Results Four hundred and fifteen managers agreed to participate, providing 904 potential participants. The response rate was 25% (223/904). Most (n = 179, 80%) were aware of the term ‘pharmaceutical public health’. While a majority saw the importance of public health to their practice (n = 177, 79%) agreeing/strongly agreeing, they were less comfortable with the term ‘specialist’. Respondents viewed competencies relating to health promotion (n = 192, 86%) more relevant than surveillance (n = 70, 31%), risk management (n = 29, 13%) and strategic developments (n = 12, 5%). Responses indicated a desire for education and training with more than half (n = 121, 54%) agreeing/strongly agreeing that they had a need now, with 69% (n = 153) expressing a future need. Conclusion Results should be interpreted with caution due to the response rate. However, this research highlights the self assessed gap in competence related to pharmaceutical public health for community pharmacists in Scotland.     

The knowledge and attitude of the Turkish community pharmacists toward pharmacovigilance in the Kadikoy district of Istanbul

Objective We investigated the knowledge and attitudes of community pharmacists towards pharmacovigilance and adverse drug reactions (ADRs) in Kadık?y district of Istanbul (Turkey). Setting The community pharmacies in Kadikoy. Kadikoy is one of the biggest districts of Istanbul and has the largest number of pharmacies. Kadikoy district was divided into two regions, the central and the peripheral. Method Between December 2005 and June 2006 we conducted a survey about the knowledge and attitude of community pharmacists (n = 219) using a face-to-face questionnaire. The questionnaire consisted of questions about the sociodemographic characteristics of the pharmacists, their knowledge of pharmacovigilance and their attitudes towards ADR reporting. Main outcomes measured The knowledge of pharmacovigilance practice, ADR reporting compliance rates, reasons for not reporting ADR and perceptions of the Turkish community pharmacists on pharmacovigilance practice were evaluated. Results Although all 411 pharmacies in the Kadikoy district were visited, only 53% of the community pharmacists (n = 219) consented to participate in the study. Of those that did respond, only 17.2% of the pharmacists had any knowledge about ‘pharmacovigilance’. Sixty-five percent of the pharmacists stated that patients reported an ADR to them during the previous 12 months, and 21% of pharmacists reported to the concerned organizations. Our survey showed that only 7% actually reported an ADR to the national pharmacovigilance center. On the other hand, 89% of the pharmacists believed that the role of the pharmacist in ADR reporting was essential. Conclusion The results show that Turkish community pharmacists have poor knowledge about pharmacovigilance. There is an urgent need for educational programs to train them about pharmacovigilance and ADR reporting.     

Community pharmacists,Internet and social media: An empirical investigation

BackgroundUse of social media and Internet for health information sharing is expanding among patients, physicians, and other health care professionals. Research on professional use of social media by community pharmacists is limited.Objectives1) To determine the extent to which Texas (U.S. state) independent community pharmacists use text messaging, email, Facebook, Twitter, and/or other information technology for professional communication with patients and health care professionals and identify the perceptions of Texas independent community pharmacists toward such usage; 2) to determine the extent to which Texas independent community pharmacists develop and employ their pharmacy websites to provide drug information and patient care services.MethodsA 25-item survey with questions addressing the objectives of the study as well as basic demographic questions (gender, age, and type of pharmacy degree) was mailed to a random sample of 1196 independent community pharmacists in Texas in January 2012.ResultsThe study response rate was 23.7%, with 284 usable questionnaires returned. The majority of respondents reported that Internet access is available at their pharmacies (98% (278)), and 91% (258) are familiar with the term ‘social media’. To communicate with health care professionals, 56% (n = 160) of respondents use email, 34% (n = 97) use text messages and 5% (n = 14) use Facebook. To communicate with patients, 36% (n = 102) of respondents use email, 30% (n = 86) use text messages and 7% (n = 19) use Facebook. The perceptions of pharmacists who communicate with patients using electronic tools about information related to drug therapy once a month or more frequently were more positive than those of pharmacists who never or hardly ever communicate with patients via electronic tools about drug therapy (P < 0.05). Over 50% of independent pharmacists reported maintaining a pharmacy website.ConclusionsThis study is the first U.S. statewide assessment of the use of electronic communication and social media for professional pharmacist's communications and perceptions toward the use of social media in patient–pharmacist communications among independent community pharmacists in Texas. Future studies conducted in other states as well as nationwide will contribute to a better understanding of the use of electronic communication, Internet, and social media in the daily professional activities of independent community pharmacists.     

Community pharmacy-based injectable naltrexone service delivery models and best practices

BackgroundOpioid use disorder (OUD) is a major public health issue in the United States. Medications for OUD (MOUD), which combines the use of approved medications with counseling and behavioral therapies, represents an evidence-based approach to treat individuals living with an OUD. However, MOUD has not kept up with increased demand and new treatment approaches are needed. One approach is injectable naltrexone, an approved and effective MOUD treatment, provided by pharmacists, who are more geographically accessible and have legal authority to administer it in some states.ObjectivesTo explore how different community pharmacists provide injectable naltrexone treatment and identify best practices.MethodsAn exploratory sequential mixed-methods design was used to investigate pharmacy-based naltrexone injection practices, involving a pharmacist questionnaire and interviews with pharmacists, prescribers, and community stakeholders. An inductive/iterative content analysis approach, guided by an initial straw model, was used to identify and explore conceptual categories for the interviews.ResultsThe final sample included 68 pharmacy surveys and 14 total interviews with pharmacists (n = 9), prescribers (n = 3), and community stakeholders (n = 2). Pharmacies providing naltrexone injections reported administering over 700 injections in the past year. Interviews revealed benefits and barriers to pharmacist-provided injections and the importance of the prescriber-pharmacist relationship in OUD treatment. Three pharmacy treatment delivery models were identified, compared to the initial straw model, and informed development of a best practices checklist for community pharmacies interested in establishing or expanding a naltrexone injection service.ConclusionsThe study demonstrates how community pharmacies developed and implemented a naltrexone injection service. Pharmacists' and prescribers' feedback clearly suggests an untapped interest, as well as resources, in realizing pharmacists’ roles as providers of injectable naltrexone treatment. Implementation research could inform the development and evaluation of an intervention based on these best practices to further explore the utility of community pharmacy-based naltrexone injection services.     

The corporatization of community pharmacy: Implications for service provision,the public health function,and pharmacy's claims to professional status in the United Kingdom

BackgroundPharmacy has experienced both incomplete professionalization and deprofessionalization. Since the late 1970s, a concerted attempt has been made to re-professionalize pharmacy in the United Kingdom (UK) through role extension—a key feature of which has been a drive for greater pharmacy involvement in public health. However, the continual corporatization of the UK community pharmacy sector may reduce the professional autonomy of pharmacists and may threaten to constrain attempts at reprofessionalization.ObjectivesThe objectives of the research: to examine the public health activities of community pharmacists in the UK; to explore the attitudes of community pharmacists toward recent relevant UK policy and barriers to the development of their public health function; and, to investigate associations between activity, attitudes, and the type of community pharmacy worked in (eg, supermarket, chain, independent).MethodsA self-completion postal questionnaire was sent to a random sample of practicing community pharmacists, stratified for country and sex, within Great Britain (n = 1998), with a follow-up to nonresponders 4 weeks later. Data were analyzed using SPSS (SPSS Inc., Chicago, IL, USA) (v12.0). A final response rate of 51% (n = 1023/1998) was achieved.ResultsThe level of provision of emergency hormonal contraception on a patient group direction, supervised administration of medicines, and needle-exchange schemes was lower in supermarket pharmacies than in the other types of pharmacy. Respondents believed that supermarkets and the major multiple pharmacy chains held an advantageous position in terms of attracting financing for service development despite suggesting that the premises of such pharmacies may not be the most suitable for the provision of such services.ConclusionsA mixed market in community pharmacy may be required to maintain a comprehensive range of pharmacy-based public health services and provide maximum benefit to all patients. Longitudinal monitoring is recommended to ensure that service provision is adequate across the pharmacy network.     

Patterns of drug-related problems and the services provided to optimize drug therapy in the community pharmacy setting

IntroductionDrug-related problems (DRPs) are events or circumstances involving drug therapy that actually or potentially interferes with desired health outcomes.ObjectivesTo assess community pharmacists’ knowledge and practice regarding DRP-reduction services, as well as the barriers and factors associated with decreased provision of these services.MethodsThis cross-sectional study utilized a validated questionnaire to assess pharmacists’ knowledge, practice, and barriers to the provision of DRP-reduction services in the community pharmacy setting. Binary regression model was used to assess the variables associated with the practice of DRP-reduction services.ResultsA total of 412 pharmacists participated in the study. The pharmacists demonstrated strong knowledge but inadequate practice of DRP-reduction services. The most reported DRPs were inappropriate combination of drugs, or drugs and herbal medications, or drugs and dietary supplements (52.4%), patients’ inability to understand instructions properly (46.1%), inappropriate drug according to guidelines (43.7%), and too high dose (40.3%). The most common barriers to these services were increased workload (60.5%), limited time (53.2%), and lack of good communication skills (49.8%). The presence of a counselling area in the pharmacy increased the practice of DRP-reduction services (OR: 3.532, 95%Cl: 2.010–5.590, P < 0.001), while increased weekly working hours (OR: 0.966, 95%Cl: 0.947–0.986), P < 0.01) and serving < 10 patients daily (OR = 0.208, 95%Cl: 0.072–0.601, P < 0.01) decreased it.ConclusionsCommunity pharmacists’ practice of DRP-reduction services showed a scope for improvement. Future pharmaceutical care initiatives should increase the number of personnel working in the pharmacy and provide them with opportunities for continued education and training in order to improve the provision of DRP services and optimize patients’ outcomes.     

Mental health,burnout and resilience in community pharmacists during the COVID-19 pandemic: A cross-sectional study

BackgroundThe study aimed to assess burnout, resilience, and levels of depression, anxiety, stress and fear among community pharmacists during the pandemic, and examine if fear of COVID-19 is associated with these outcomes of interest.MethodsA cross-sectional survey of community pharmacists in Qatar was conducted. Pharmacists’ burnout was measured by the Maslach Burnout Inventory: Human Services Survey for Medical Personnel (MBI-HSS? for MP-Mindgarden). Resilience was assessed using the Connor-Davidson Resilience Scale-10 (CD-RISC-10). Depression, anxiety, and stress were measured by the Depression, Anxiety, and Stress Scale (DASS-21). Fear of COVID-19 was assessed by the Fear of COVID-19 Scale (FCV-19S).Results256 respondents completed the survey and were included in the final study analysis (response rate: 42.7%). Overall, participants reported a moderate level of burnout as illustrated in the mean scores of the three burnout dimensions; 20.54 (SD = 12.37) for emotional exhaustion, 6.76 (SD = 6.22) for depersonalization, and 36.57 (SD = 9.95) for personal accomplishment. Moreover, depression, anxiety and stress were reported by 44.8%, 53.2% and 25.4% of particiants respectively. Participants had shown moderate resilience (mean score: 27.64 (SD = 8.31)) and their mean score fear of COVID19 was 15.67 (SD = 6.54). Fear of COVID-19 was a statistically significant and an independent predictor of depression, anxiety, and stress levels.ConclusionsThe pharmacists experienced moderate burnout but moderate resilience, which indicates their potential to overcome difficulties. Future interventions at the personal, national and organizational levels are required to enhance the pharmacists’ wellbeing by decreasing stress, improving self-efficacy and resilience, and preventing burnout.     

A study investigating the community pharmacist knowledge about the appropriate use of inhaler,Eastern Region AlAhsa,Saudi Arabia

The current study aims to assess the community pharmacist’s skills to make correct use of metered dose inhalers (MDIs). Seventy-four pharmacists were approached using six clusters from the most populous areas of Alahsa, Eastern region Saudi Arabia. Of whom n = 71, responses were taken in consideration to perform the statistical analysis. Scoring of pharmacist demonstration was done using a nine-step checklist for the appropriate use of inhaler. A simulated patient approach was used to assess pharmacist’s skill. Majority, 98.6% of the pharmacists were Egyptian nationals with a mean age of 38.74 ± SD 4.52. Overall, pharmacists were found to have a poor recognition (mean score = 4.2 ± SD 2.08) with the steps considered while using an inhaler. However, significantly better knowledge differences were observed among the pharmacists aged 30–35 years (5.52 ± 2.14, t = 2.851, p = 0.009¹). In addition, job experience (3–4 years) was found significantly (p = 0.003¹) associated with a better knowledge toward the appropriate use of inhaler. It was seen that the young pharmacists working on chain pharmacies have comparatively better knowledge than the other groups.     

Association of hospital pharmacy–related knowledge and skills with occupational stress of clinical pharmacists in tertiary hospitals of China

ObjectiveOccupational stress of health care providers may lower the quality of care. Person-environment fit theory and practical evidence have indicated that various types of knowledge and skills of health care providers are differentially associated with occupational stress. Clinical pharmacists are an indispensable part of medical teams. Clinical pharmacists in China are generally under high occupational stress, but what kind of knowledge and skills can relieve their occupational stress remains unclear. This study aimed to assess the association between the specific knowledge and skills of clinical pharmacists and their occupational stress in China. This study aimed to assess the association between the specific knowledge and skills of clinical pharmacists and their occupational stress in China.MethodsA field questionnaire survey using a stratified sampling was conducted to gather data on occupational stress, knowledge and skills related to hospital pharmacy, and other factors of occupational stress using the Brief Job Stress Questionnaire and a self-developed instrument. Ordinary least squares regression was used to evaluate the association of the participants’ knowledge, skills, and other factors with their occupational stress.ResultsA total of 625 clinical pharmacists from 311 tertiary hospitals in China (response rate = 84%) participated. Knowledge of or skills related to pharmaceutical care service provision (P = 0.02), the use of computers and the Internet in pharmacy practice (P = 0.02), interpersonal communication (P = 0.10), or pharmacoepidemiology (P = 0.08) was associated with reduced occupational stress of the participants. Participants who had credentials of nation-level specialized (P = 0.09) and general training (P = 0.04) for clinical pharmacist had lower degrees of occupational stress than those without these credentials. The participants’ clinical professions, routine tasks, technical titles, and type of hospital they work in were also associated with their occupational stress.ConclusionEnhancing several aspects of knowledge or skills among clinical pharmacists in tertiary hospitals in China may help reduce their occupational stress. Efforts are needed to improve the education and training system of clinical pharmacists in China.     

Community pharmacy and the extended community pharmacist practice roles: The UAE experiences

Background: The pharmaceutical care and ‘extended’ roles are still not practiced optimally by community pharmacists. Several studies have discussed the practice of community pharmacy in the UAE and have shown that most community pharmacists only counsel patients. However, UAE, has taken initiatives to allow and prepare community pharmacists to practice ‘extended’ roles. Aim of the review: The aim was to review the current roles of community pharmacists in Abu Dhabi Emirate, United Arab Emirates (UAE). Objective: The objective was to encourage community pharmacists toward extending their practice roles. Methods: In 2010, Health Authority Abu Dhabi (HAAD) surveyed community pharmacists, using an online questionnaire, on their preferences toward extending their counseling roles and their opinion of the greatest challenge facing the extension of their counseling roles. Results: Following this survey, several programs have been developed to prepare community pharmacists to undertake these extended counseling roles. In addition to that, HAAD redefined the scope of pharmacist roles to include some extended/enhanced roles. Abu Dhabi Health Services (SEHA) mission is to ensure reliable excellence in healthcare. It has put clear plans to achieve this; these include increasing focus on public health matters, developing and monitoring evidence-based clinical policies, training health professionals to comply with international standards to deliver world-class quality care, among others. Prior to making further plans to extend community pharmacists’ roles, and to ensure the success of these plans, it is imperative to establish the views of community pharmacists in Abu Dhabi on practicing extended roles and to gain understanding and information on what pharmacists see as preferred change strategies or facilitators to change. Conclusions: In an attempt to adapt to the changes occurring and to the growing needs of patients and to maximize the utilization of community pharmacists’ unique structured strategies are needed to be introduced to the community pharmacy profession.     

The relationships among work stress,strain and self-reported errors in UK community pharmacy

BackgroundChanges in the UK community pharmacy profession including new contractual frameworks, expansion of services, and increasing levels of workload have prompted concerns about rising levels of workplace stress and overload. This has implications for pharmacist health and well-being and the occurrence of errors that pose a risk to patient safety. Despite these concerns being voiced in the profession, few studies have explored work stress in the community pharmacy context.ObjectivesTo investigate work-related stress among UK community pharmacists and to explore its relationships with pharmacists' psychological and physical well-being, and the occurrence of self-reported dispensing errors and detection of prescribing errors.MethodA cross-sectional postal survey of a random sample of practicing community pharmacists (n = 903) used ASSET (A Shortened Stress Evaluation Tool) and questions relating to self-reported involvement in errors. Stress data were compared to general working population norms, and regressed on well-being and self-reported errors.ResultsAnalysis of the data revealed that pharmacists reported significantly higher levels of workplace stressors than the general working population, with concerns about work-life balance, the nature of the job, and work relationships being the most influential on health and well-being. Despite this, pharmacists were not found to report worse health than the general working population. Self-reported error involvement was linked to both high dispensing volume and being troubled by perceived overload (dispensing errors), and resources and communication (detection of prescribing errors).ConclusionsThis study contributes to the literature by benchmarking community pharmacists' health and well-being, and investigating sources of stress using a quantitative approach. A further important contribution to the literature is the identification of a quantitative link between high workload and self-reported dispensing errors.     

An objective evaluation of fundamental pharmacogenomics knowledge among pharmacists and pharmacy students

IntroductionPossessing a correct and comprehensive foundation on the science of pharmacogenomics (PGx) is an important prerequisite for pharmacists to successfully apply pharmacogenomic testing to patient care. While some work has addressed general PGx knowledge among pharmacists, little research has specifically focused on PGx foundational knowledge. This study examines the level of foundational knowledge of PGx and interest in learning about PGx among community pharmacists and first-year pharmacy students at Beirut Arab University (BAU), Beirut, Lebanon.MethodsA cross-sectional survey was self-administered to community pharmacists within a random sample of community pharmacies in Beirut, Lebanon, and to first-year BAU pharmacy students. The knowledge component of the instrument consisted of 25 items, each worth one point, addressing fundamental PGx information. The validity and internal consistency of the designed instrument were tested among the study population. Correlation analysis was carried out between aggregate knowledge and key variables for participating pharmacists.ResultsOf 150 approached pharmacists, 137 (91 %) participated and of 132 pharmacy students, 131 (99 %) participated. The average knowledge score for community pharmacists was 15 (Standard Deviation = 4) out of a possible total of 25 with the total number of correct answers ranging from 8 to 24 out of 25 questions. The average score for pharmacy students was 17 (Standard Deviation = 5) out of a possible total of 25 with the total number of correct answers ranging from 5 to 24. Pharmacists’ age and years of practice were associated with a lower aggregate knowledge score (r = ?0.20; p < 0.05 and r = ?0.21; p < 0.05), respectively. Pharmacists’ interest in learning about PGx varied whereas 62 % were either interested or very interested in learning about PGx. Students’ interest, however, was higher with 70 % being either interested or very interested. Specific PGx topics of interest to participants were highlighted.ConclusionThis study identified areas where PGx foundational knowledge was acceptable and others where significant opportunities for improvement exist. These results add to the rapidly expanding field of pharmacogenomics education and practice in relation to pharmacy. In particular, these findings have significant implications for planning pharmacogenomics-related educational activities targeting current and future pharmacists.     

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

BackgroundCommunity 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.ObjectivesTo 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.MethodsThe 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.ResultsAll 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.ConclusionsCommunity 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.     

Community pharmacy in Australia: A health hub destination of the future

BackgroundRates of chronic illness are rising in Australia and as medications are frequently used in the management of a range of chronic conditions, community pharmacists are in an ideal position to better assist these consumers. There is currently limited information as to how pharmacy can do this from the perspective of consumer health organizations, health advocates and professional support organizations.ObjectivesTo explore new roles, opportunities and any associated barriers for community pharmacy to better assist consumers with chronic illnesses.MethodsRepresentatives of non-government consumer health organizations (n = 10) were interviewed from the key health priority areas emphasized by the Australian government. Health advocates (n = 3), innovative health care professionals (n = 4) and representatives of health care professional organizations (n = 4) from pharmacy and medicine also participated. Interviews were analyzed via thematic analysis.ResultsTwenty-one in-depth interviews were conducted. The core finding was the potential for community pharmacies to become a health hub destination, whereby pharmacy staff assist consumers with chronic conditions to: navigate the health system (e.g., provide information on support services), manage their medications, and provide health advocacy. Participants expressed their concern that consumers may not be aware of the breadth of the pharmacist's expertise and that further collaboration is needed with non-government consumer health organizations and other health providers. Emphasis was placed on the improvement of the pharmacist's current role, particularly in the area of medication advice and accessibility, with the current pharmacy remuneration model identified as a barrier to becoming a health hub destination.ConclusionThe eventual progression toward a health hub destination was seen to be important to better assist consumers with chronic conditions. This focuses on a more proactive approach to care encompassing simple advice, referrals to consumer health organizations and ultimately, health advocacy. However, further research is required into how community pharmacy can become a health hub given that this is a new concept and there are existing professional barriers.