The changing face of pharmacy practice — evidence from 20 years of work sampling studies

Objectives — To determine whether the professional policy shift away from dispensing towards patient‐focused care is reflected in the way community pharmacists actually use their time. Method — Retrospective comparison, using data from five observational work sampling studies employing the same methodology. The percentage of time spent on manipulative dispensing (defined as creating labels and physically preparing prescription items) and health‐related customer communication was monitored. Setting — Fifteen independent practices (8.7 prescriptions/hour; London, England, 1993); 40 urban/rural pharmacies (7.8 prescriptions/hour; Dublin, Eire, 1985); 28 independents (9.1 prescriptions/hour; Sydney, Australia, 1985); one traditional multiple (9.6 prescriptions/hour; Nova Scotia, Canada, 1980); 20 traditional multiples (8.1 prescriptions/hour; eastern United States, 1973). Key findings — Despite full computerisation, English pharmacists in 1993 spent as much time creating dispensing labels (8.8 per cent) as they did on health‐related customer talk (7.2 per cent), and twice as much time preparing prescription items (14.2 per cent). Of their total time, 6.5 per cent was spent on simple redispensing (mostly counting tablets, pouring liquids and cutting blister strips). The time spent on extemporaneous preparation was extremely low. In Eire, pharmacists spent nearly twice as much time (5.8 per cent) on health‐related talk as on counting, pouring and compounding (3.8 per cent) and in Australia nearly three times as much time (6.6 per cent vs 2.3 per cent). In Eire, two‐thirds of pharmacists had qualified dispensing help of a type not found in other countries. In Australia, most products were ready to issue. Conclusion — The proportion of pharmacist time spent on customer communication has increased three‐fold since 1973. However, this has not been mirrored by a decline in time spent on manipulative dispensing. Keeping the study limitations in mind, it is suggested that, in Britain, the reprofessionalisation process may be hampered by the continued need for redispensing and the limited availability and use of trained support staff.