Community pharmacists' perceptions of services that benefit older people in New Zealand.
BACKGROUND
There is limited information in New Zealand about community pharmacists' perceptions of services that benefit older people.


OBJECTIVE
To explore the perceptions of community pharmacists' of services that benefit older people; the benefits perceived; and the experiences of pharmacists providing such services.


METHODS
Community pharmacies in New Zealand.


METHODS
A cross-sectional purpose-developed survey was carried out of all community pharmacies in New Zealand. This was followed by twenty qualitative telephone interviews of pharmacists identified as providing at least one specialized service. Interviews were recorded, transcribed verbatim, and coded for themes using constant comparison.


METHODS
Community pharmacists' opinions and perceptions in the cross-sectional survey and qualitative interviews.


RESULTS
Responses were received from pharmacists in 403/905 evaluable pharmacies. All pharmacies provided some baseline services (advice, dispensing of prescriptions, medicines disposal) and 90% provided home deliveries of medicines. Adherence to medicines was supported by compliance packaging (96%), medication review (Medicines Use Review, MUR) (28%), and repeat prescription reminders (27%). Thirty-five percent provided screening (e.g. cholesterol, blood pressure), and 32% provided medicines education to community groups. Compliance packaging and home delivery were thought the services most beneficial for older people, and should help people adhere to their medicines. The 20 pharmacists interviewed by telephone provided 20 different specialized services (median 2, range 1-4). These included MUR, services to residential homes, visiting educators/special clinics, INR monitoring, services to hospices, and flu vaccination. Benefits perceived included improvements in adherence, patient safety, and patient-knowledge of medicines, and convenient access to services. "Patient need" was a frequent driver of services, and common facilitators for services were having appropriate training/skills, co-operation with health professionals, peer or expert support, sufficient time and funding. A lack of these facilitators were considered barriers as were resistance from general practitioners or the general public, or high set-up costs.


CONCLUSIONS
Community pharmacists in New Zealand perceived they provide a range of services of potential benefit to older people for managing their medicines. Establishing new services requires cooperation from other health professionals, peer support, training, funding and time. Further research into patients' outcomes from new and established services is needed.
School of Pharmacy, University of Otago, 18 Frederick Street, Dunedin, 9054, New Zealand. june.tordoff@otago.ac.nz
June
J
Tordoff
Shih Yen
SY
Chang
Pauline T
PT
Norris
D000367:Age Factors; D001291:Attitude of Health Personnel; D016009:Chi-Square Distribution; D003157:Community Pharmacy Services / Q000458:organization & administration; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006302:Health Services Research; D006299:Health Services for the Aged / Q000458:organization & administration; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009520:New Zealand; D010043:Outcome and Process Assessment, Health Care; D010465:Perception; D010595:Pharmacists / Q000458:organization & administration / Q000523:psychology*; D036301:Qualitative Research; D011795:Surveys and Questionnaires