Factors associated with the intensity of government remunerated and unremunerated service provision in community pharmacies

Background: Many community pharmacies provide medication and disease state management services with and without specific remuneration. Availability of these services is often reported, however little is known about factors influencing the intensity of their provision. Objective: To investigate factors associated with the intensity of provision of selected government remunerated and unremunerated community pharmacy services in Western Australia (WA). Methods: A questionnaire was mailed to a random sample of 421/628 (67%) community pharmacies in WA. The first dependent variable was intensity of government remunerated MedsCheck and Diabetes MedsCheck service frequencies per month. The second was the intensity of the sum of government unremunerated asthma screening, blood glucose testing, cholesterol testing and smoking cessation disease state management service frequencies per week. Principal Component Analysis defined attitudinal components influencing service provision. Linear regression with bootstrap confidence intervals determined variables associated with intensity of provision of the selected services. The variables were: pharmacist; pharmacy setting characteristics; and, attitudinal factors. Results: The questionnaire yielded a response rate of 49.2%. Attitudinal components that facilitated service provision were: general practitioners (GPs) willingness to collaborate; pharmacists are capable and ready; and pharmacists require further training. Staff capability and low return on investment were barriers to increased service provision. The intensity of government remunerated services was independently associated with pharmacies having pharmacy interns, fewer dispensary technicians, and being capable and ready to provide the services. Higher intensity of the provision of the unremunerated disease state management services was independently associated with the intensity of provision of MedsCheck and Diabetes MedsCheck services. Conclusions: Improved pharmacy workflow, achieved by the availability of pharmacy interns, and pharmacists being capable and ready, were important factors in the intensity of MedsCheck and Diabetes MedsCheck services. Intensity of the provision of government remunerated services facilitated a higher prevalence of disease state management services provision.