Preferences of Community Pharmacists for Extended Roles in??Primary Care

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Abstract
Background: Major changes in the roles and responsibilities of pharmacists across the world are occurring. A new Scottish Community Pharmacy contract was introduced in April 2006, following the introduction of a similar contract in England in 2005. This contract encourages greater involvement in medicines management and other clinical cognitive roles, whilst retaining a supply function. Objective: To use a discrete choice experiment (DCE) to examine the strength of preference of community pharmacists for existing and potential new roles, prior to the introduction of the new contract. Study design: The DCE was a component of a larger questionnaire, which assessed demography, workload, attitudes to, and satisfaction with, proposed new roles, and current levels of activity. Attributes and levels for the DCE were based on the recent policy document for Scotland, The Right Medicine, and informed consensus, respectively. Scenarios were organised into pairs, and pharmacists were asked “Which job would you prefer?” The questionnaire was mailed to all pharmacists working in the community setting in Scotland (n = 1621), as identified from a telephone survey. The questionnaire was totally anonymous, and two reminders were sent. Results: There was an overall response rate of 56.4% (914/1621). Community pharmacists preferred to work in an extended pharmacy team, to have strong integration with secondary care, and to provide a minor illness advice service. In 2003, they would forgo an annual income of £3443, £2183 and £2798, respectively to achieve this. However, overall, the pharmacists preferred more income to less. Repeat dispensing, chronic disease management, offering health promotion services, and the number of prescriptions dispensed per month were not significant predictors of job choice. Conclusion: Community pharmacists placed the highest value on organisational aspects of their work, and having a first contact primary care role. Although total income was important, there were indications that they would be prepared to forgo income to attain their preferred job.