There is ample evidence to suggest that there can be considerable variability in pharmacists’ tenacity to provide comprehensive care to patients.
The pharmacy profession is continually enrapt in a debate about professional autonomy and the corporatization of the profession. Indeed, some decisions by certain players in the medication use process do not always help pharmacists practice at the top of their license, and our reimbursement and rewards mechanisms remain far from ideal. Some might complain that this corporatization stymies pharmacist caring, and ultimately their effectiveness. However, there is ample evidence to suggest that regardless of employer, there can be considerable variability in pharmacists’ tenacity to provide comprehensive care to patients. Pharmacists’ traits and beliefs can have an impact.
This was demonstrated in a study published in the Journal of the American Pharmacists Association.1 The investigators identified factors associated with pharmacists’ likelihood of providing antidepressant treatment (ADT) monitoring. The population eligible for the study included all community pharmacists within the Canadian province of Quebec who had worked over 20 hours during the previous month.
Pharmacists’ thoroughness in providing ADT monitoring was calculated and defined by a composite score from 1 to 5 based upon their answers to 3 questions in a survey soliciting their frequency of performing certain interventions on behalf of patients taking antidepressants. The researchers then employed the Theory of Planned Behavior (TPB) to determine possible factors governing variability in pharmacists’ composite ADT monitoring scores.
The likelihood of pharmacists’ scoring higher on the ADT measure was a direct result of their intention to perform these monitoring activities. Their intentions to do so were accurately predicted by all of the TPB variables. This included their attitude toward providing ADT monitoring, their subjective norms for doing so (attitude that other persons believe their ADT monitoring is important), perceived behavioral control (the extent to which they have the ability, including time and autonomy, to perform ADT monitoring), behavioral beliefs (beliefs that performing ADT would improve patient adherence and promote customer loyalty), and control beliefs (beliefs that performing ADT is feasible even if the chain of command doesn’t favor it and even if it takes an additional amount of time to doing so). Also significant were pharmacists’ perceptions of facilitating factors. For example, they would perform more ADT monitoring if they had proper training and if the work of technicians was restructured so that the pharmacist had more time.
There is so much to learn from this study. Lack of time and perceived unease from administrators can be barriers to providing the most effective care, but those barriers can still be overcome by pharmacists determined to provide the highest level of care possible. Pharmacy managers would do well to hire pharmacists with the right attitudes and beliefs to provide the highest care for patients, show appreciation for the pharmacists who do so, and do all that they can to provide the proper resources and structure for those pharmacists to practice effectively, regardless of whether the work is taking place in an independent pharmacy or in a larger organization.
Additional information about “Human Resource Management Functions and Ensuring Quality in Pharmacy Operations”can be foundin Pharmacy Management: Essentials for All Practice Settings, 5e online at AccessPharmacy.
Shane P. Desselle, RPh, PhD, FAPhA, Professor of Social/Behavioral Pharmacy at Touro University California in Vajello.
Lauzier S, Guillaumie L, Humphries B, Gregoire JP, et al. Psychosocial factors associated with pharmacists’ antidepressant drug treatment monitoring. J Am Pharm Assoc. 2020.60(4):548-558.