Threatening and violent incidents in community pharmacies: (2) Implications for pharmacists and community pharmacy services

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Abstract
This paper reports the second stage of a study into threatening and violent incidents in community pharmacies. The first stage, an investigation of the frequency and nature of incidents, found that a high proportion of practising pharmacists had been threatened and/or assaulted while at work (see p136). The implications of security issues for pharmacists, and how these affect the services they are prepared to offer, are addressed in this paper. Data were collected in semi-structured interviews with pharmacists who had reported one or more threatening or violent incidents. Many respondents described serious events with lasting psychological effects, including anxiety about their own safety and changed attitudes towards clients. Pharmacists' concerns about personal safety influenced them in their decisions regarding the services they offered. Pharmacists felt vulnerable at opening and closing times and believed that services to intravenous drug users increased the risks of an event; many incidents did actually occur at these times and involve this group of people. Concerns about safety and security affected late-night and out-of-hours dispensing, services to IV drug users and domiciliary visits. More surprisingly, pharmacists also reported effects on their general dispensing and advice-giving activities. The role of pharmacists in primary health care is becoming more prominent as the Government promotes community based care and encourages individuals to take more responsibility for their own health. Concerns about safety and security could hamper the continuation and development of professional services. The profession must acknowledge the potential impact of these issues in its aspirations and recommendations regarding its future primary care role.