title: Analysis of enhanced pharmacy services in rural community pharmacies in Western Australia.
abstract: BACKGROUND
  Enhanced pharmacy services (EPS) are health related services above those normally available with the supply of medicines. Rural pharmacies could provide a diversity of EPS in response to the limited access and reduced health services available in rural areas. The objective of this study was to evaluate the provision of EPS in rural Western Australian (WA) pharmacies in 2006, compared with findings extracted from a national survey conducted in 2002. Barriers to and facilitators for the provision of ETS in rural settings were also analysed.
  
  
  METHODS
  The survey was conducted in 2006, using a questionnaire developed from a 2002 Australian national survey questionnaire. The questionnaires were mailed to all 103 pharmacies in rural WA and 51 were returned (49.5%). Chi-squared tests were used to test associations between year of survey and provision of each EPS. Where significant associations were reported, logistic regression analyses that controlled for sex, age, PhARIA location (remoteness), and inclusion of a forward pharmacy area were performed.
  
  
  RESULTS
  The WA rural pharmacies offered a range of EPS. There were marked increases in weight testing and weight management services. The availability of smoking cessation services increased from 52% of rural pharmacies in 2002 to 63% in 2006. Other EPS (asthma, diabetes, hypertension, hyperlipidaemia), which correspond to the Australian Government National Health Priorities Areas were offered by 20% to 50% of pharmacies and had not increased between surveys. A continued shortage in the pharmacist workforce was a major barrier to EPS provision.
  
  
  CONCLUSIONS
  Provision of EPS in rural pharmacies is more important than in metropolitan pharmacies because there is often a lack of other sources for these services in rural and remote locations. A range of defined EPS were provided by 25% to 60% of rural and remote pharmacies, with other services offered in lower percentages. Significant increases were found in some important EPS, such as weight management. Additional support for EPS provision in rural and remote communities is required to increase uptake among pharmacists. Government and pharmacy bodies need to implement rural practice models to address identified pharmacist workforce barriers and improve access to EPS to rural communities.
authors.affiliation: Curtin University of Technology, Perth, Western Australia, Australia. yosiw@yahoo.com
authors.forename: Yosi
authors.initials: Y
authors.lastname: Wibowo
authors.forename: Constantine
authors.initials: C
authors.lastname: Berbatis
authors.forename: Andrew
authors.initials: A
authors.lastname: Joyce
authors.forename: V B
authors.initials: VB
authors.lastname: Sunderland
mesh_terms: D001315:Australia; D001835:Body Weight; D002908:Chronic Disease / Q000628:therapy; D003157:Community Pharmacy Services / Q000458:organization & administration*; D006297:Health Services Accessibility / Q000458:organization & administration; D006302:Health Services Research; D006801:Humans; D019035:Rural Health Services / Q000458:organization & administration*; D016540:Smoking Cessation / Q000379:methods