This study identified previously reported facilitators and barriers to pharmacist-client communication and then evaluated their impact on the observed communication behaviors of pharmacists. Pharmacists (n = 100) completed a seven-page questionnaire collecting information on 11 variables that had been organized according to the Policy, Regulatory and Organizational Constructs in Educational and Ecological Development (PROCEDE) model as predisposing, enabling, or reinforcing of pharmacist communication with their clients. Demographic variables also were included. “Communication quality” served as the study’s dependent variable, whereas pharmacist responses served as the independent variables. Communication quality scores for each pharmacist were obtained from the analysis of 765 audio recordings of verbal exchanges occurring between the study pharmacists and their consenting clients during 4-hour, on-site observation periods. Four of the variables examined in the study were found to share a unique relationship with communication quality (pharmacists’ attitude, year of graduation, adherence expectations, and outcome expectations). Hierarchical multiple regression analysis revealed that the variables measured in the questionnaire accounted for 23% of the variance in communication quality scores. Plausible explanations for why the study was unable to capture more of the variance in its proposed relationships and future areas for research are provided.
Get full access to this article
View all access options for this article.
References
1.
Anderson, C. (1995). A controlled study of the effect of a health promotion training scheme on pharmacists’ advice about smoking cessation. Journal of Social and Administrative Pharmacy, 12, 115-124.
2.
Barnes, J. M., Riedlinger, J. E., McCloskey, W. W., & Montagne, M. (1996). Barriers to compliance with OBRA ‘90: Regulations in community pharmacies. Annals of Pharmacotherapy, 30, 1101-1105.
3.
Barnett, C., Nykamp, D., & Hopkins, W., Jr. (1992). An evaluation of pharmacists’ OTC drug consultations. Journal of Pharmacy Marketing and Management, 6, 33-49.
4.
Bennis, W. G., Benne, K. D., Chin, R., & Corey, K. E. (Eds). (1976). The planning of change. New York: Holt, Rinehart and Winston.
5.
Berger, B. A., & Grimley, D. (1997). Pharmacists’readiness for rendering pharmaceutical care. Journal of the American Pharmaceutical Association, NS37, 535-542.
6.
Brushwood, D. B. (1995). The pharmacist’s expanding legal responsibility for patient care. Journal of Social and Administrative Pharmacy, 12, 53-62.
7.
Burman, D. (1992). Health promotion and the future of pharmacy. On Continuing Practice, 19, 17-20.
8.
Bush, P. J. (Ed.). (1983). The pharmacist role in disease prevention and health promotion. Bethesda, MD: ASHP Research and Education Foundation.
9.
Campagna, K. D., & Newlin, M. H. (1997). Key factors influencing pharmacists’ drug therapy decisions. American Journal of Health Systems Pharmacy, 54, 1307-1313.
10.
Campbell, R. K., Baker, D., Jinks, M., & Evenson-St. Amand, L. (1989). Compliance with Washington state’s professional practice regulations: 1974 vs. 1987. American Pharmacy, NS29, 350-356.
11.
Chase, G. (1979). Implementing a human services program: How hard will it be? Public Policy, 27, 384-435.
12.
College of Pharmacists of British Columbia. (1992). Bulletin, 17, 1.
13.
Coultas, D. B. (1991). The physician’s role in smoking cessation. Clinics in Chest Medicine, 2(4), 755-768.
14.
Farris, K. B., & Kirking, D. M. (1993). Assessing the quality of pharmaceutical care: Application of concepts from Medical Care. Drug Intelligence and Clinical Pharmacy, 27, 215-223.
15.
Farris, K. B., & Kirking, D. M. (1998). Predicting community pharmacists’choice among means to prevent and correct clinically significant drug-therapy problems. Journal of Social and Administrative Pharmacy, 15, 69-82.
16.
Farris, K. B., & Schopflocher, D. P. (1999). Between intention and behaviour: An application of community pharmacists’ assessment of pharmaceutical care. Social Science and Medicine, 49, 55-66.
17.
Fern, F. H. (1993). New pharmacy mandates and practice standards now taking effect under OBRA ‘90 deadline. Healthspan, 10(3), 12-14.
18.
Fincham, J. E., & Smith, M. C. (1988). Pharmacists’ views about health promotion practice. Journal of Community Health, 13, 115-123.
19.
Fink, J. L. (1995). Liability and the changing role of pharmacists. American Pharmacy, NS35, 34-35.
20.
Fisher, C., Corrigan, O., & Henman, M. (1991). A study of community pharmacy practice. 3. Non-prescribed sales and counselling. Journal of Social and Administrative Pharmacy, 8, 69-75.
21.
Gardner, M. E., & Sennott-Miller, L. (1987, January/February). Pharmacist participation in a health-promotion project for the elderly. American Society of Consultant Pharmacists, pp. 62-65.
22.
Green, L. W., & Fedder, D. (1977). Drug information, the pharmacist, and the community. American Journal of Pharmacy Education, 41, 444-448.
23.
Green, L. W,. & Kreuter, M. W. (1999). Health Promotion Planning: An Educational and Ecological Approach (3rd ed.). Toronto: Mayfield.
24.
Hepler, C., & Strand, L. (1990). Opportunities and responsibilities for pharmaceutical care. American Journal of Pharmacy Education, 53S, 7S-14S.
25.
Higby, G. J. (1996). From compounding to caring: An abridged history of American pharmacy. In C. H. Knowlton & R. P. Penna (Eds.), Pharmaceutical Care. Toronto: Chapman and Hall.
26.
Kirking, D. (1982). Pharmacists’ perceptions of their patient counseling activities. Contemporary Pharmacy Practice, 5, 230-238.
27.
Kirking, D. (1984). Evaluation of an explanatory model of pharmacists’patient counseling activities. Journal of Social and Administrative Pharmacy, 2, 50-56.
28.
Knapp, D. A., Wolf, H. H., Knapp, D. E., & Rudy, T. A. (1969). The pharmacist as a drug advisor. Journal of the American Pharmaceutical Association, NS9, 502-505, 543.
29.
Kuiz, F. J., Clark, M. A., Prochaska, T. R., Slezak, J. A., Crittenden, K. S., Freels, S., et al. (1995). Attitudes and practices for smoking cessation counselling by provider type and patient age. Preventive Medicine, 24, 201-212.
30.
Laurier, C., Archambault, A., & Contandriopoulos, A. P. (1989). Communication of verbal information by community pharmacists. Annals of Pharmacotherapy, 23, 862-868.
31.
Laurier, C., & Poston, J. (1992). Perceived levels of counseling among Canadian pharmacists. Journal of Social and Administrative Pharmacy, 9, 104-113.
32.
Lawrence, A. J. (1991, March). Healthy People 2000: The community RPh’s role in health promotion and disease prevention. Pharmacy Times, pp. 35-38.
33.
Lewis, C. E., Clancy, C., Leake, B., & Schwartz, J. S. (1991). The counselling practices of internists. Annals of Internal Medicine, 14, 54-58.
34.
Maddux, J. E., Stanley, M. A., & Manning, M. M. (1987). Self-efficacy theory and research: Applications in clinical and counseling psychology. In J. E. Maddux, C. D. Stoltenberg, & R. Rosenwein (Eds.), Social Processes in Clinical and Counseling Psychology (pp. 39-55). New York: Springer-Verlag.
35.
Mason, H., & Svarstad, B. (1984). Medication counseling behaviours and attitudes of rural community pharmacists. Annals of Pharmacotherapy, 18, 409-414.
36.
McBean-Cochrane, B. (1992). Information for patients. International Journal of Pharmacy Practice, 1, 121-122.
37.
McDonald, R. M. (1991). Assessment of organizational context: a missing componentin evaluations of training programs. Evaluation and Program Planning, 14, 273-279.
38.
Moos, R. H. (1988). Assessing the program environment: Implications for program evaluation and design. New Directions for Program Design, 14, 273-279.
39.
Morrow, N., & Hargie, O. (1992). Patient counseling: An investigation of core situations and difficulties in pharmacy practice. International Journal of Pharmacy Practice, 1, 202-205.
40.
Mullen, P. D., & Holcomb, J. D. (1990). Selected predictors of health promotion counselling by three groups of allied health professionals. American Journal of Preventive Medicine, 63, 153-160.
41.
Munroe, W. P., & Rosenthal, T. G. (1994). Implementing pharmaceutical care: Evolution vs. revolution. American Pharmacy, NS34, 57-69.
42.
Nichol, M., & Michael, L. (1992). Critical analysis of the content and enforcement of mandatory consultation and patient profile laws. Annals of Pharmacotherapy, 26, 1149-1155.
43.
Odedina, F. T., Segal, R., & Hepler, C. D. (1995). Providing pharmaceutical care in community practice: Differences between providers and non-providers of pharmaceutical care. Journal of Social and Administrative Pharmacy, 12, 170-180.
44.
Orlandi, M. A. (1987). Promoting health and preventing disease in health care settings: An analysis of barriers. Preventive Medicine, 16, 119-130.
45.
Ortiz, M., Walker, W. L., & Thomas, R. (1992). Development of a measure to assess community pharmacists’ orientation towards patient counselling. Journal of Social and Administrative Pharmacy, 9, 2-10.
46.
Ottoson, J. M. (1995). Use of a conceptual framework to explore multiple influences on the application of learning following a continuing education program. Canadian Journal of Adult Education, 9, 1-18.
47.
Ottoson, J. M. (1997). After the applause: Exploring the multiple influences on application following adult education programs. Adult Education Quarterly, 47, 92-107.
48.
Paluck, E. C., Stratton, T. P., & Eni, G. O. (1994). Community pharmacists participation in health education and disease prevention activities. Canadian Journal of Public Health, 85, 389-392.
49.
Paluck, E. C., Stratton, T. P., & Eni, G. O. (1996). Community pharmacists and health promotion: A study of thirteen variables. Journal of Social and Administrative Pharmacy, 13, 88-89.
50.
Perreault, W. D., & Leigh, L. E. (1989). Reliability of nominal data based on qualitative judgements. Journal of Marketing Research, 26, 135-148.
51.
Perry, C. L., Baranowski, T., & Parcel, G. S. (1990). How individuals, environments and health behaviour interact: Social learning theory. In K. Glanz, F. M. Lewis, & B. K. Rimer (Eds.), Health Behaviour and Health Education: Theory, Research and Practice. San Francisco: Jossey-Bass.
52.
Raisch, D. (1993a). Barriers to providing cognitive services. American Pharmacy, NS33, 54-58.
53.
Raisch, D. (1993b). Patient counseling in community pharmacy and its relationship with prescription payment methods and practice settings. Annals of Pharmacotherapy, 27, 1173-1179.
54.
Sanazaro, P. J. (1983). Determining physicians’ performance: Continuing education and other interacting variables. Evaluation and the Health Professions, 6, 197-210.
55.
Schommer, J. C., Sullivan, D. L., & Haugtvedt, C. L. (1995). Patients’role orientation for pharmacist consultation. Journal of Social and Administrative Pharmacy, 12, 33-41.
56.
Schommer, J., & Wiederholt, J. (1994). Pharmacists views of patient counseling. American Pharmacy, NS34, 46-53.
57.
Scott, D. M., & Wessels, M. J. (1997). Impact of OBRA ‘90 on pharmacists’patient counseling practices. Journal of the American Pharmaceutical Association, NS37(4), 401-406.
58.
Sidel, V., Beizer, J., Lisi-Fazio Kleinmann, K., Wenston, J., Thomas, C., & Kelman, H. (1990). Controlled study of the impact of educational home visits by pharmacists to high-risk older patients. Journal of Community Health, 15, 163-174.
59.
Sisson, E. M., & Israel, M. K. (1996). Extent of community-based delivery of pharmaceutical care in Virginia. Pharmacotherapy, 16, 94-102.
60.
Sleath, B. (1996). Pharmacist-patient relationships: Authoritarian, participatory, or default? Patient Education and Counseling, 28, 253-263.
61.
Smith, F. (1992a). Community pharmacists and health promotion: A study of consultations between pharmacists and clients. Health Promotion International, 7, 249-255.
62.
Smith, F. (1992b). A study of the advisory and health promotion activity of community pharmacists. Health Education Journal, 51, 68-71.
63.
Smith, F. J., Salkind, M. R., & Jolly, B. C. (1990). Community pharmacy: A method of assessing quality of care. Social Science and Medicine, 31(5), 603-607.
64.
Smith, M. C., & Gibson, J. T. (1974). The pharmacist and preventive medicine. Journal of the American Pharmaceutical Association, NS14, 131-135.
65.
Thompson, J. E. (1993). Teaching pharmacy students effective patient consultation skills. American Journal of Pharmacy Education, 57, 185-190.
66.
Upjohn Company of Canada. (1990). Canadian Pharmacy Services Study 1990. Patient Counselling Study: A Survey Among Community Pharmacists. Author.
67.
Upjohn Company of Canada. (1992). Canadian Pharmacy Services Study 1992: The Future of Canadian Community Pharmacy. Author.
68.
Weschler, H., Levine, S., Idelson, R., Rohman, M., & Taylor, J. O. (1983). The physician’s role in health promotion-Asurvey of primarycare practitioners. New England Journal of Medicine, 308, 97-100.
69.
Wiederholt, J., Clarridge, B., & Svarstad, B. (1992). Verbal consultation regarding prescription drugs: Findings from a statewide study. Medical Care, 30, 59-73.
70.
Willison, D. J., & Muzzin, L. J. (1995). Workload, data gathering, and quality of community pharmacists’ advice. Medical Care, 33, 29-40.
71.
Wilson, R. (1992). Health promotion: Whose job is it? Canadian Family Physician, 38, 336-339.
