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Anne Walker, Margaret Watson, Jeremy Grimshaw, Christine Bond, Applying the theory of planned behaviour to pharmacists' beliefs and intentions about the treatment of vaginal candidiasis with non-prescription medicines, Family Practice, Volume 21, Issue 6, December 2004, Pages 670–676, https://doi.org/10.1093/fampra/cmh615
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Abstract
Background. It is important to understand health professionals' attitudes and beliefs about practice and the barriers to achieving best practice. The theory of planned behaviour (TPB) has been widely used to understand behaviour. In this study, TPB was used to explore the psychological variables that influence community pharmacists and the supply of non-prescription medicines.
Objectives. The objectives of the study were to: (i) apply the TPB to community pharmacy behaviour; (ii) identify barriers to/facilitators of evidence-based practice; (iii) describe psychological variables and responses to written scenarios of patients presenting in community pharmacies for non-prescription antifungals for the treatment of vulvovaginal candidiasis; and (iv) to examine the relationships between beliefs and behavioural intention.
Methods. A questionnaire survey was constructed using the TPB and disseminated to pharmacies in Grampian, Scotland. The purpose of the study was to explore community pharmacists' attitudes, beliefs and intentions about the supply of non-prescription antifungals for the treatment of vulvovaginal candidiasis.
Results. Of the 121 questionnaires disseminated, 76 (63%) were returned. Behavioural intention to sell antifungals to women with vulvovaginal candidiasis symptoms was strong. Attitude towards recommending these medicines was positive. However, only half of the sample responded appropriately to all four patient scenarios (n = 42, 54%). Most pharmacists felt that they were able to recommend antifungals if they wished, but did not feel under social pressure to recommend them. Local doctors did not appear to be influential with respect to selling antifungals. If a customer was elderly, pregnant or if the pharmacist was uncertain of the diagnosis of candidiasis, an antifungal was less likely to be recommended.
Conclusion. TPB provides a valid and useful summary of the key psychological variables influencing practice. There is more to pharmacy practice than the knowledge and attitudes of the pharmacist.
Comments
Dear Sir,
In their recent study, Walker and colleagues found that pharmacists felt able to recommend anti-fungals to women with symptoms of vaginal candidiasis.(1) In the UK, since 1999, women have also been able to purchase the Emergency Contraceptive Pill (ECP) from pharmacists. In December ’05, we conducted a small pilot questionnaire survey over a period of two months in order to investigate the proportion of women who obtained the ECP free on prescription versus bought over-the-counter (OTC), from South London pharmacies.
We contacted 21 pharmacists in SW London of which 6 were willing to participate in the study. The pharmacists were requested to distribute an information sheet and questionnaire to consecutive women requesting the ECP. The questionnaire inquired as to whether the women were purchasing the ECP OTC or obtaining it free on prescription, and their reasons for this. It also asked about demographic data (age, ethnicity, previous use of ECP, employment status) and intention of future use. Completed questionnaires were placed in sealed envelopes and retained by the pharmacists for collection by JF on a fortnightly basis. Women under the age of 16 and women who did not speak English were excluded from the study. Data from the questionnaires were entered and analysed using SPSS v12.0.
Of the 70 questionnaires distributed to the pharmacists, 31 were returned completed, by two months. The mean age of respondents was 24 years (range 16-34). Subjects described their ethnicity as White 68%, Black 23%, Asian 7% and other ethnic group 2%. 14 women (45%) said they were employed. 18 (58%) of the women had bought the ECP OTC, the remainder obtained it on prescription (62% from their GP, 23% from a family planning clinic and 15% from an Accident and Emergency department). Of those who were employed, 10/14 (71%) bought the ECP OTC compared with 5/13 (38%) of those who were not employed. This difference was not statistically significant, although the small size of the sample must be acknowledged.
Women purchased the ECP OTC because it is fast, convenient and easy to obtain. This applies particularly at weekends when most likely to be required, and when family planning clinics or GPs are generally closed. Like Walker and colleagues, our study highlights the important role of pharmacists in promoting sexual health.
References:
1. Walker AE, Watson M, Grimshaw JM, Bond C. Applying the theory of planned behaviour (TPB) to treatment of vaginal candidiasis in community pharmacies. Family Practice 2004;21:670-676.
Conflict of Interest:
None declared