Background: An increased interest is observed in broadening community pharmacists� role in public health. To\r\ndate, little information has been gathered in Canada on community pharmacists� perceptions of their role in health\r\npromotion and prevention; however, such data are essential to the development of public-health programs in\r\ncommunity pharmacy. A cross-sectional study was therefore conducted to explore the perceptions of community\r\npharmacists in urban and semi-urban areas regarding their ideal and actual levels of involvement in providing\r\nhealth-promotion and prevention services and the barriers to such involvement.\r\nMethods: Using a five-step modified Dillman�s tailored design method, a questionnaire with 28 multiple-choice or\r\nopen-ended questions (11 pages plus a cover letter) was mailed to a random sample of 1,250 pharmacists out of 1,887\r\ncommunity pharmacists practicing in Montreal (Quebec, Canada) and surrounding areas. It included questions on\r\npharmacists� ideal level of involvement in providing health-promotion and preventive services; which services were\r\nactually offered in their pharmacy, the employees involved, the frequency, and duration of the services; the barriers to\r\nthe provision of these services in community pharmacy; their opinion regarding the most appropriate health\r\nprofessionals to provide them; and the characteristics of pharmacists, pharmacies and their clientele.\r\nResults: In all, 571 out of 1,234 (46.3%) eligible community pharmacists completed and returned the questionnaire.\r\nMost believed they should be very involved in health promotion and prevention, particularly in smoking cessation\r\n(84.3%); screening for hypertension (81.8%), diabetes (76.0%) and dyslipidemia (56.9%); and sexual health (61.7% to\r\n89.1%); however, fewer respondents reported actually being very involved in providing such services (5.7% [lifestyle,\r\nincluding smoking cessation], 44.5%, 34.8%, 6.5% and 19.3%, respectively). The main barriers to the provision of\r\nthese services in current practice were lack of: time (86.1%), coordination with other health care professionals\r\n(61.1%), staff or resources (57.2%), financial compensation (50.8%), and clinical tools (45.5%).\r\nConclusions: Although community pharmacists think they should play a significant role in health promotion and\r\nprevention, they recognize a wide gap between their ideal and actual levels of involvement. The efficient\r\nintegration of primary-care pharmacists and pharmacies into public health cannot be envisioned without\r\naddressing important organizational barriers.
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