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Skill-mix more important for quality of community pharmacy services than staffing levels, study finds

Researchers from the University of Manchester found that continuity of patient care in giving advice, and whether community pharmacies used locums regularly, were “an important predictor” of quality services.

Skill-mix in community pharmacy has a bigger influence on the quality of services a pharmacy provides than overall staffing numbers, a study has found.

The findings, published in (18 September 2019), were based on a survey of 277 community pharmacies in England across nine different geographical districts with varying degrees of deprivation.

Some 971 patients from 39 of the pharmacies were also surveyed as part of the study, which was designed to discover the extent to which pharmacy organisation influenced quality of services. The factors considered were patient safety, patient satisfaction and patients’ adherence to medicines advice.

Their results revealed that patient satisfaction with their pharmacy visit was associated with employment of pharmacy technicians (beta=0.0998, 95% confidence interval [CI] 0.0070–0.1926) and continuity of the advice-giver (beta=0.2593, 95% CI 0.1251–0.3935).

Patient satisfaction with information they received was also associated with continuity of advice giver (odds ratio [OR]=1.96, 95% CI 1.36–2.82).

Continuity of patient care in giving advice, and whether community pharmacies used locums regularly, were also “an important predictor” of quality services, the researchers noted.

Regular deployment of locums by pharmacists was associated with poorer medicines adherence (OR=0.50, 95% CI 0.30–0.84]), the study found.

The research team, from the University of Manchester, concluded: “The current findings are amongst the first to demonstrate that interpersonal continuity in community pharmacy services is not only important for patient satisfaction, but may also influence clinical effectiveness in terms of medication adherence.

“This is an important finding for community pharmacies relying on locum pharmacists and those larger chains where regular rotation of pharmacists is common practice.”

The type of pharmacy ownership, organisational culture and service volume were not significant predictors of any of the patient outcomes looked at by the researchers, who also noted that their findings should be interpreted with caution as four large multiples would not take part in the research so they were unable “to capture the full range of variation” between different pharmacy organisations and cultures.

 

Citation: Electronicjuice DOI: 10.1211/PJ.2019.20207101

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