Community pharmacists’ current perceptions of medication counseling in Japan: classification by latent class analysis

Abstract

Rationale, Aims and Objectives: Under the latest government healthcare initiatives in Japan, community  pharmacists  are now required to undertake “person-oriented”, in addition to the material-oriented, work that has been their professional foundation. Medication counseling is regarded as integrated interpersonal work at community pharmacies, but there is no research on how practising community pharmacists view their mission as described by the Government. Our main objective was to investigate how Japanese community pharmacists perceive their medication counseling role and perform typology analysis using latent class analysis (LCA).

Methods: The study was a cross-sectional, self-administered, web-based survey of community pharmacists in Japan. A 5-item questionnaire with a 5-point scale was developed and the responses were employed for LCA. Respondents’ general behavior and attitudes in providing patient-centered pharmaceutical care were rated by 2 questions, which were part of a validated questionnaire for a behavioral pharmaceutical care scale. Demographic information and operational conditions at pharmacy level were also collected. These variables were used for logistic regression with the classes. Survey invitations were delivered to 2,600 pharmacies and all responses were collected in June and July 2016.

Results: A total of 1,332 pharmacists responded. More than 70% thought it difficult to understand the “true” medication adherence of patients. While more than 95% believed it was important to take patients’ personalities and characteristics into account, only 50% rated themselves as competent to communicate in an individually tailored manner with patients. LCA revealed 4 classes. Class 1 (“less enthusiastic,” 42%) comprised more women and had shorter experience of clinical practice. Class 2 (“challenge-seeking,” 34.3%) was younger and less confident but provided pharmaceutical care at the average level. Class 3 (“mature professional leadership,” 20.8%) had relatively longer experience of clinical practice and were more active in cooperating with physicians. Class 4 (“indifferent,” 2.9%) was less distinctive.

Conclusion: Japanese community pharmacists are aware of their expected roles in medication counselling, but are not sufficiently confident or enthusiastic in performing them. They are characterized as different types because underlying factors vary in individual pharmacists. Considering such heterogeneity could be helpful in designing better education and development programs for community pharmacists.