Does community pharmacy offer women family‐friendly working conditions and equal opportunities? The accounts of female community pharmacists over the age of 30

Objective The sex mix of the pharmacy workforce has altered significantly over the last 60 years such that in 2005 54% of the practising pharmacy workforce was female. After the age of 30 years, part‐time working is common and it is often assumed that pharmacy working attracts and suits women because it is flexible and family friendly. This paper aims to explore to what extent that is true. Setting This study was based in the North West of England. Method Face‐to‐face interviews (n=30) were conducted with women over the age of 30 years who worked as community pharmacists. The interview schedule was designed to explore: interviewees' motivation for choosing pharmacy; employment history; motivation for choosing a particular pattern of working; views of recent changes in pharmacy; and future career plans. Key findings In line with previous studies this sample of female community pharmacists adopted heterogenous work patterns, and personal and extrinsic structural factors were found to influence work patterns. Importantly, there was evidence of a lack of family‐friendly practices, with antisocial hours, difficulties accommodating annual leave, and the restrictive legislative framework that necessitates that a pharmacist is always present in a store, all affecting work patterns. Conclusion Our study, in contrast to other studies, suggests that for about half of the women interviewed, community pharmacy working was difficult to combine with family commitments. This finding has implications for employers and workforce planners because an increasing proportion of the community pharmacy workforce is female.     

Increasing community pharmacy workloads in England: causes and consequences

Objective To explore English community pharmacists experiences of workload increases. Setting North West of England. Method Ninety-six women and 71 men replied (response rates = 40 and 31%, respectively). Thirty female pharmacists and 29 male pharmacists were interviewed between February 2005 and February 2008. The study involved semi-structured face-to-face interviews with theoretically sampled respondents. Interviews were recorded and transcribed verbatim and a thematic analysis conducted. Main outcome measures English community pharmacists?? opinions and experiences. This paper specifically considers the following themes, community pharmacists?? accounts of workload, role expansion, skill mix, management support, coping strategies, perceptions of patient safety, and impact on pharmacists health and well-being. Results Respondents reported escalating workloads in community pharmacy, which most respondents linked to increased stress and decreased job satisfaction. There were striking differences in the work patterns described by the male and female community pharmacists. Male interviewees commonly worked full time, in senior positions in community pharmacy. Female interviewees commonly worked part time as employees. This study suggests that interviewees perceived that skill mix initiatives were not currently helped pharmacists deal with rising workload demands. Additionally, this study found some evidence that work intensification resulted in decreased health and well-being and prompted concerns about patient safety. Community pharmacists are more vulnerable to work intensification than other health care professions. The demand-control-support model was applied to understand causes of work related stress. Interviews described using problem based coping strategies to combat stressful working environments. Conclusions Workloads have increased in community pharmacy and the work environment has become increasingly stressful. Consideration of the factors shaping community pharmacy point to continued workload increases. This is likely to have a negative impact on pharmacists and conceivably the services they provide. Skilled support staff, supportive management and appropriate resourcing are required to maintain high quality services.     

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.     

Determination of the drug information needs of the medical staff of a Nigerian hospital following implementation of clinical pharmacy services

The types and frequency of questions asked of clinical pharmacists introducing clinical pharmacy services in the internal medicine wards of a Nigerian university hospital and the degree of compliance with pharmacists' recommendations were studied. Three faculty pharmacists collected data in two 30-working day study periods, separated by a year. Totals of 197 questions (an average of 6.57 +/- 1.33 questions/working day) and 271 questions (an average of 9.03 +/- 1.10 questions/working day) were answered by the pharmacists in the first and second study periods, respectively. Pharmacists recommended changes in patient-specific drug therapy that were implemented 52 percent and 69 percent of the time in the first and second study periods, respectively. The most common type of drug information request concerned the presence or the likelihood of an adverse drug reaction. Continuous interaction between pharmacists and physicians in the patient-care setting results in a better appreciation of the pharmacist's role as drug information consultant, and the consequence of this is a high degree of compliance with pharmacists' recommendations.     

Pharmacists' perceptions of consumer demand for patient-oriented pharmacy services

This study examined pharmacists' perceptions of consumer demand for various patient-oriented pharmacy services. Data on pharmacists' perceptions were gathered by a mail questionnaire of pharmacist-managers in Raleigh, NC. Conjoint and regression analyses indicate that pharmacists perceive little demand either for voluntary provision of advisory services or for patient medication records, and that pharmacists' perceptions of the demand for patient medication records relate significantly to their provision of this service. Comparison of pharmacists' perceptions of demand with previously collected consumer data indicates that pharmacists underestimate the demand for patient medication records but not for voluntary provision of advisory services. These findings suggest that pharmacists' perception of consumer demand is as important as actual consumer demand in explaining why pharmacists do not provide patient-oriented pharmacy services more frequently.     

Clinical services provided by staff pharmacists in a community hospital

A program for developing staff pharmacists' clinical skills and documenting pharmacists' clinical interventions in a large community teaching hospital is described. A coordinator hired in 1984 to develop clinical pharmacy services began a didactic and experiential program for baccalaureate-level staff pharmacists. Fourteen educational modules are supplemented by journal and textbook articles and small-group discussions of clinical cases, and the clinical coordinator provides individual training on the patient-care units for each pharmacist. Monitoring of clinical pharmacy services began in June 1987; each intervention provided by a pharmacist is recorded on a specially designed form. A target-drug program is used to document cost avoidance achieved through clinical services. Information collected through these monitoring activities is used to educate the pharmacy staff, shared with the pharmacy and therapeutics committee, and used to monitor prescribing patterns of individual physicians. The data are used in the hospital's productivity-monitoring system. All pharmacists who were on staff in 1984 have completed the educational modules, and all new employees are in the process. Since monitoring began, the number of clinical interventions has averaged 2098 per month. Cost avoidance has averaged $9306 per month. Over a five-year period, the development of staff pharmacists' clinical services raised the level of professional practice, produced substantial cost avoidance, and increased the number of pharmacist interventions in medication use.     

Trends in full-time pharmacists' labor market characteristics

OBJECTIVE: To provide a historical overview of the pharmacy profession for the past 30 years, using trends in full-time pharmacists' labor market characteristics. METHODS: A retrospective longitudinal sample of pharmacists from 1968 to 1996 was constructed from the March Current Population Survey data. A three-period centered moving average method was used to describe the labor market trends over time. Pharmacists' labor market was characterized by age, sex, race, education, geographic distribution, salary, working hours, and wage. RESULTS: The dominant age group among full-time pharmacists was 36-45 in the late 1960s and early 1970s, 26-35 between the mid-1970's and early 1990's, and 36-45 in the mid-1990's. Historically, a significant proportion of full-time pharmacists were white men, holding bachelor's degrees. The number of pharmacists has been highest in the South and lowest in the West. In general, pharmacists' annual salary and wage rates have grown steadily, whereas average hours worked per week have decreased from 50 hours to less than 45. CONCLUSION: Findings suggest a growing trend of three demographic groups: aged 36-45, women, and nonwhite. In addition, an increasing proportion of pharmacists holding "higher than bachelor" degrees was observed. The distribution of pharmacists was highest in the South and lowest in the West. The Midwest has the highest pharmacist/population ratio, the South the lowest. On average, full-time pharmacists in the 1990s work 40-45 hours per week, have an annual salary higher than $55,000 (in 1996 dollars), and an hourly wage rate above $25.     

Future of emergency contraception lies in pharmacists' hands.

OBJECTIVE: To increase community pharmacists' awareness about issues related to the provision of emergency contraception (EC) to women by describing pharmacist outreach and training programs and discussing pharmacy access and stocking issues, California's EC Pharmacy Program, methods for raising pharmacists' awareness, and professional development opportunities. SUMMARY: EC is both safe and effective in reducing the risk of unintended pregnancy after unprotected intercourse, yet awareness of and demand for the medication has not been high, and it often is not stocked in pharmacies. Various advocacy organizations have engaged in educating the public and physicians about EC, but relatively little attention and few resources have been targeted to ensure that the pharmacy community is aware of and educated about EC. Increased visibility and access to EC in the several states that allow pharmacists to provide EC directly to women have resulted from the active participation and leadership of pharmacists. In these states, women are showing interest in and receptivity to reproductive health services provided by pharmacists. In California, some 3000 pharmacists statewide have completed training, and in 2004 they provided EC directly to approximately 175,000 women. Pharmacists who provide EC overwhelmingly (91%) report that they do so because they see it as an important community service, and many (57%) recognize the opportunity for professional development. CONCLUSION: Pharmacists are uniquely positioned to improve access to EC, and leadership within the pharmacy community can facilitate efforts to improve access. Increased education and training of pharmacists about EC--such as continuing education programs available online at www.pharmacyaccess. learnsomething.com--are critical to ensure not only that EC is available in pharmacies but also that pharmacists are engaged in meeting the reproductive health needs of women. Increased access to EC can expand pharmacists' role in health care provision. State-specific information about EC pharmacy access initiatives is available on the Web at www.GO2EC.org.     

Cooperation in pharmacy education in Canada and the United States

Although the education of student pharmacists and the practice of pharmacy in Canada have many similarities with that in the United States, there also are differences. The planning of curricula in pharmacy education is of particular importance to the advancement of pharmacy in Canada because of significant changes in the scope of practice in several provinces, and in how community pharmacy is reimbursed for the services it can, or should, provide. Greater dialog between Canadian and American pharmacists has the potential not only to impact practice on both sides of the border but also to improve collaborations among Canadian and American pharmacy educators. This article provides background information and some suggestions on how to build partnerships in pharmacy education between Canada and the United States. Consortia-like arrangements have some particular promise, as does engaging border-states and provinces in regional meetings and other activities. By working together, Canadian and US pharmacy educators have the opportunity to implement the best of what each has to offer and to devise new and better ways to educate future and existing pharmacists.     

Pharmacists' desired and actual times in work activities: evidence of gaps from the 2004 National Pharmacist Workforce Study.

OBJECTIVES: To describe pharmacists' work activities in the United States during 2004 in terms of (1) the desired amount of time they would like to spend in each of four work activities (medication dispensing, consultation, business management, drug use management), (2) the amount of time they actually spend in each activity, and (3) the gaps between desired and actual time reported in each activity. DESIGN: Cross-sectional study. SETTING: Pharmacies (community chain, community independent, hospital, and other) in the United States. PARTICIPANTS: 1,564 actively practicing pharmacists. INTERVENTION: Mailed survey from portions of the 2004 National Pharmacist Workforce Survey. MAIN OUTCOME MEASURES: Differences between desired and actual time spent in work activities in medication dispensing, consultation, business management, and drug use management and the associations between practice setting characteristics and demographic variables were explored using linear and logistic regression analyses. Practice variables included position, years in current position, working part time, work with other pharmacists, work with technicians, proportion of staff who are pharmacists, staff size, dispensing level. Demographic variables included age, gender, race, marital status, and year of licensure with respondents' reported work activity amounts and gaps. Linear regression results were interpreted based on standardized beta coefficients and corresponding P values. Logistic regression results were interpreted based on 95% confidence intervals for odds ratios. RESULTS: The proportion of time pharmacists devoted to medication dispensing, consultation, business management, and drug use management did not change between 2000 and 2004. Practice setting was the most consistently influential variable on pharmacists' work activities when controlling for other variables. Pharmacists in all practice settings would like to spend more time in consultation and drug use management and less time in medication dispensing, but compared with community pharmacists, hospital and other patient care pharmacists were less likely to report a gap between desired and actual time spent in dispensing activities. Age was a significant predictor of gaps between desired and actual time spent in various activities, but only the oldest age groups (ages of 60 or 70 years and older) were significantly different from the reference group of pharmacists aged 23 to 30 years. CONCLUSION: Pharmacists would like to devote more of their time to consultation and drug use management activities in community pharmacy settings but have not yet been afforded a full opportunity to engage in these activities to the extent that they desire.     

Perspectives of community pharmacists on conscientious objection to provide pharmacy services: A theory informed qualitative study

BackgroundIn recent years, pharmacists have been opting out of certain pharmacy services, particularly, providing contraceptives, for moral reasons. No research has been conducted on the perceptions of community pharmacists toward conscience objection in a secular state with a mostly Muslim population.ObjectiveThis study aimed to provide an in-depth understanding of the factors related to the beliefs of community pharmacists on conscientious objection to provide pharmacy services contrary to their personal beliefs based on the theory of planned behavior.MethodsSemistructured interviews were conducted with a purposive sampling of community pharmacists. A hybrid deductive and inductive qualitative analysis approach was used on the data that were recorded and transcribed verbatim. Constructs related to attitude, subjective norm, and perceived behavioral control were explored.ResultsIn total, 25 community pharmacists were interviewed. Factors affecting pharmacists’ decision to provide pharmacy services when their personal beliefs included the desire to maintain moral integrity, beliefs about consequences for health care service, profit, patient pressure, precedence of professional values, and care for religious sources.ConclusionMost of the community pharmacists were against the behavior of conscientiously objecting to provide pharmacy services in Turkey because of possible negative consequences on health care. The pharmacists who were willing to act based on their personal beliefs were expecting from various third parties to fulfill certain responsibilities to facilitate to adopt the behavior. This novel study highlights the urgent need for more research and training for community pharmacists serving patients in different socioeconomic contexts in both developed and developing countries.     

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

Objectives To explore the reasons why recently qualified pharmacists had chosen to follow non‐standard career paths, or were thinking of doing so. Methods Participants in a nationwide longitudinal cohort study examining pharmacy careers who were either working in non‐standard roles (i.e. not primarily employed in community, primary care or hospital pharmacy), or who had expressed a likelihood of leaving the profession in the near future, were invited to participate in a follow‐up qualitative study. After pilot work to inform the design of a semi‐structured interview schedule 12 telephone interviews were conducted with pharmacists who had qualified within the last 5 years. Key findings Regardless of the sector in which these early career pharmacists had gained work experience, there was a common occurrence of workload pressures influencing career decisions. Pressures in community pharmacy were often related to the need to meet certain targets in a business environment. Community pharmacists also bemoaned a lack of resources, such as support staff, which often meant that their day‐to‐day routines became monotonous and unfulfilling. A feeling of being undervalued and underutilised was the main concern voiced by all pharmacists and represented the views of those with experience of working in both the community and hospital sectors. This situation arose because participants felt that they had been highly trained to deliver new pharmaceutical services yet the opportunities to use their skills did not materialise, partly due to the nature of their workloads. Conclusions Early career pharmacists can become disillusioned because the pressure to perform routine tasks often results in a lack of time to provide new pharmaceutical services. Increased job satisfaction levels are seen when more opportunities for clinical input are afforded to pharmacists. This could be achieved through the use of clear guidelines on staffing levels and, more importantly, the provision of adequate support staff.     

Diabetes care in Norwegian pharmacies: a descriptive study

OBJECTIVE: To describe Norwegian pharmacies' involvement in diabetes care, to investigate pharmacists' views on future services and to investigate whether the recommendations in the Norwegian diabetes declaration for pharmacies have been implemented. Setting Hospital and community pharmacies in Norway. METHOD: All 543 pharmacies in Norway, of which 511 were community pharmacies and 32 were hospital pharmacies, received a link to a web-based questionnaire. One pharmacist from each pharmacy was asked to complete the questionnaire. The questionnaire covered subjects ranging from the diabetes declaration and the pharmacists' views on which services the pharmacy should offer in the future, to demographic characteristics. RESULTS: In total 358 (66%) questionnaires were completed. The diabetes declaration was read by 37% of the pharmacists. Almost all pharmacies complied with the declarations' recommendations regarding glucose monitoring services. Twenty four percent of the pharmacies could offer medication reviews, and roughly 10% could offer screening for undiagnosed diabetes. Counseling on lifestyle issues was the least implemented recommendation. Eighty one percent of the pharmacists reported a wish to expand their services towards diabetes patients. Services in regard to glucose monitoring had the highest score, however the views on which services should be offered varied a great deal. Already performing a service increased the chance of the pharmacist being positive towards offering it. CONCLUSION: Norwegian pharmacists report that they are involved in a wide range of diabetes related services, although only 37% report to have read the diabetes declaration. The pharmacists generally wish to actively support patients with diabetes, and further research should concentrate on identifying the areas where their involvement is most productive.