title: Are community-based pharmacists underused in the care of persons living with HIV? A need for structural and policy changes.
abstract: OBJECTIVE
  To describe community pharmacists' perceptions on their current role in direct patient care services, an expanded role for pharmacists in providing patient care services, and changes needed to optimally use pharmacists' expertise to provide high-quality direct patient care services to people living with human immunodeficiency virus (HIV) infections.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Four Midwestern cities in the United States in August through October 2009.
  
  
  METHODS
  28 community-based pharmacists practicing in 17 pharmacies.
  
  
  METHODS
  Interviews.
  
  
  METHODS
  Opinions of participants about roles of specialty and nonspecialty pharmacists in caring for patients living with HIV infections.
  
  
  RESULTS
  Pharmacists noted that although challenges in our health care system characterized by inaccessible health professionals presented opportunities for a greater pharmacist role, there were missed opportunities for greater level of patient care services in many community-based nonspecialty settings. Many pharmacists in semispecialty and nonspecialty pharmacies expressed a desire for an expanded role in patient care congruent with their pharmacy education and training.
  
  
  CONCLUSIONS
  Structural-level policy changes needed to transform community-based pharmacy settings to patient-centered medical homes include recognizing pharmacists as important players in the multidisciplinary health care team, extending the health information exchange highway to include pharmacist-generated electronic therapeutic records, and realigning financial incentives. Comprehensive policy initiatives are needed to optimize the use of highly trained pharmacists in enhancing the quality of health care to an ever-growing number of Americans with chronic conditions who access care in community-based pharmacy settings.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Kibicho
authors.forename: Steven D
authors.initials: SD
authors.lastname: Pinkerton
authors.forename: Jill
authors.initials: J
authors.lastname: Owczarzak
authors.forename: Lucy
authors.initials: L
authors.lastname: Mkandawire-Valhmu
authors.forename: Peninnah M
authors.initials: PM
authors.lastname: Kako
mesh_terms: D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D003157:Community Pharmacy Services / Q000592:standards; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000592:standards; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy*; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007587:Job Description; D054539:Medication Therapy Management; D015146:Midwestern United States; D010348:Patient Care Team / Q000592:standards; D061214:Patient Safety; D010465:Perception; D010595:Pharmacists / Q000523:psychology / Q000592:standards; D024382:Professional Role; D011369:Professional-Patient Relations; D011785:Quality Assurance, Health Care; D013038:Specialization
chemical_list: D019380:Anti-HIV Agents