Research Brief
Can pharmacy assistants play a greater role in public health programs in community pharmacies? Lessons from a chlamydia screening study in Canberra, Australia

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Abstract

Background

Little is known about the engagement of pharmacy assistants (PA) in public health service provision.

Objective

To explore the experiences of PA participating in a study to determine whether a cash reward, offered to consumers and pharmacy businesses, increased participation in community pharmacy-based chlamydia screening.

Methods

PA experience of the study education and training package, participant recruitment and conducting screening (providing information about chlamydia, specimen collection and handling urine samples) were evaluated using knowledge assessment, a questionnaire and focus groups.

Results

Twenty PA participated in the study: 15 (75%) completed all education and training components, 20 (100%) completed the questionnaire and 10 (50%) attended a focus group. PA rated all education and training components as effective (mean visual analog scale scores >8.5). Most PA (13/18, 72.2%) did not support/were unsure about continuing the program, citing the 25% repeat testing rate (presumed to relate to the cash reward) and privacy/confidentiality issues as reasons. Qualitative analysis suggested that minimizing repeat testing, improved workload management and recognition of, and remuneration for, education and training would make this model more acceptable to PA.

Conclusion

Findings from this study support the assertion that PA can play a significant role in public health initiatives.

Introduction

Factors such as location, convenience, anonymity, extended opening hours and immediate access to a qualified health professional contribute to the increasing role community pharmacies are playing in public health.1, 2, 3, 4 Growth in this area is constrained because service delivery usually relies on the availability of pharmacists.5, 6, 7 Expanding the role of paraprofessional staff to deliver public health services offers one solution.8, 9 Pharmacy assistants (PA) are staff trained to appropriately sell pharmacy medicines, some are technicians or dispensers. PA are the ‘public face’ of community pharmacy. They are ideally placed to fulfill this role as they constitute the majority of the pharmacy workforce, are generally the initial contact for consumers and conduct the majority of health triage interactions, but not all PA feel adequately trained to expand their role.10

Studies show that pharmacy staff can provide public health services such as smoking cessation,6 weight management,11 sexual health,12 and drug use,13, 14 but few studies have determined PA attitudes toward this development.15 One New Zealand study found not all staff wish to expand their current roles,16 while in England, counter staff in 10 community pharmacies were receptive to providing public health advice.17 During a study designed to determine if a AUD10 cash reward increased participation of males and females in chlamydia screening in community pharmacies, we explored the experiences of the PA involved.

Section snippets

Methods

This mixed methods study was approved by research ethics committees of the Australian Capital Territory Government Health Directorate, the University of Canberra and the Australian National University. Pharmacists and PA were asked to offer chlamydia screening to people aged 16–30 years attending their pharmacy for any reason. Participants who returned a urine sample were rewarded with AUD10. The study was advertised through radio, television and print media. The uptake of screening, and the

Results

Thirty-six PA from six pharmacies enrolled to take part in the study. Of these, 20 (55%) completed all components of the education and training package and the post study questionnaire; 10 attended a focus group (Table 2). PA enrolled the majority of young people into the study. Most (95%) PA completing the questionnaire were female; 50% were aged 16–30 years.

All 20 PA scored >80% in the knowledge assessment. The questionnaire mean sufficiency scores regarding manual 1 (chlamydia), manual 2

Discussion

PA played a significant role in this sexual health study. We suggest that to maximize their effectiveness in public health roles, attention must be paid to: identifying and meeting education and training needs, exploring PA attitudes toward the target population/s and the public health issue being addressed, exploring options for appropriate remuneration and including PA at every stage of the change processes required to expand their role.

Staff education and training contribute to the delivery

Conclusion

PA experiences in this study support the assertion that this workforce can play a significant role in delivering public health services. PAs were satisfied with their education and training and were receptive to expanding their public health role. They rapidly recruited a large number of young people of both sexes to be screened for chlamydia, but expressed some concerns. Implementation of strategies to minimize the number of repeat testers, better manage the pharmacy workload and promote and

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