title: Cardiovascular Disease Risk Assessment in Australian Community Pharmacy.
abstract: BACKGROUND
  Population screening and monitoring of cardiovascular risk is suboptimal in Australian primary care. The role of community pharmacy has increased considerably, but without any policy framework for development. The aim of this study was to explore the nature of community pharmacy-based screening models in Australia, capacity to increase delivery of pharmacy screening, and barriers and enablers to increasing capacity.
  
  
  METHODS
  An online survey weblink was emailed to pharmacy managers at every quality-accredited pharmacy in Australia by the Quality Pharmacy Care Program. The 122-item survey explored the nature of screening services, pharmacy capacity to deliver services, and barriers and enablers to service delivery in considerable detail. Adaptive questioning was used extensively to reduce the participant burden. Pharmacy location details were requested to facilitate geo-coding and removal of duplicate entries. A descriptive analysis of responses was undertaken.
  
  
  RESULTS
  There were 294 valid responses from 4890 emails, a 6% response rate. Most pharmacies (79%) had private counselling areas. Blood pressure assessment was nearly universal (96%), but other common risk factor assessments were offered by a minority. Most did not charge for assessments, and 59% indicated capacity to provide multiple risk factor assessments. Fewer than one in five (19%) reported any formal arrangements with general practice for care coordination. Financial viability was perceived as a key barrier to service expansion, amid concerns of patient willingness to pay. Support from government and non-governmental organisations for their role was seen as necessary.
  
  
  CONCLUSIONS
  There appears to be a critical mass of pharmacies engaging in evidence-based and professional services. Considerable additional support appears required to optimise performance across the profession.
authors.affiliation: Deakin Rural Health, Faculty of Health, Deakin University, Melbourne, Vic, Australia; Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Vic, Australia. Electronic address: kevin.mcnamara@deakin.edu.au.
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Mc Namara
authors.affiliation: Unit for Medicines Outcomes Research and Evaluation, Pharmacy, School of Medicine, University of Tasmania, Hobart, Tas, Australia.
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Peterson
authors.affiliation: Unit for Medicines Outcomes Research and Evaluation, Pharmacy, School of Medicine, University of Tasmania, Hobart, Tas, Australia.
authors.forename: Josie
authors.initials: J
authors.lastname: Hughes
authors.affiliation: Faculty of Pharmacy, University of Sydney, Sydney, NSW, Australia.
authors.forename: Ines
authors.initials: I
authors.lastname: Krass
authors.affiliation: Deakin Rural Health, Faculty of Health, Deakin University, Melbourne, Vic, Australia.
authors.forename: Vincent
authors.initials: V
authors.lastname: Versace
authors.affiliation: School of Nursing and Midwifery, Faculty of Health, Flinders University, Adelaide, SA, Australia.
authors.forename: Robyn A
authors.initials: RA
authors.lastname: Clark
authors.affiliation: Deakin Rural Health, Faculty of Health, Deakin University, Melbourne, Vic, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Dunbar
mesh_terms: D001315:Australia / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D010594:Pharmacies; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: Absolute risk; Community pharmacy; Community screening; Disease prevention; Primary care