The status, barriers and associated facilitators of pharmaceutical care provision in public tertiary healthcare settings: a cross-sectional perspective from a low-middle-income country

Pharmaceutical care is the responsible provision of medication therapy with the motive of improving patients’ quality of life. This study aimed to evaluate the current status, barriers and facilitators of pharmaceutical care provision in tertiary healthcare settings of six major metropolitan cities of Punjab, Pakistan. A cross-sectional survey using convenience sampling method was conducted by administering validated questionnaire. The study was based on pharmacists’ self-reported practices gathered through either in-person interviews or Google Forms. Data was analyzed using SPSS version 25. Simple descriptive statistics and Chi-square test were used to assess the associations between demographic variables and study outcomes (P < 0.05 considered significant). Overall, 127 participants were included in the final analysis. There were 121 (95.3%) respondents who reported adherence to rules while purchasing medications, 70 (55.1%) of respondents acknowledged the presence of a clinical pharmacist, 94 (74.0%) affirmed their commitment to provide counselling at the time of discharge. Significant associations were found between the qualification of pharmacists and the presence of a clinical pharmacist system (P = 0.018). Working experience was associated with inadequate staffing (P = 0.016), patient counseling at discharge (P = 0.018) and lack of trust from physicians (P = 0.002). Lack of administrative support 70 (55.1%), shortage of clinical pharmacists 98 (77.1%), lack of physician’s trust 64 (50.4%), inadequate staffing 78 (61.6%), and patient unawareness of pharmacist’s role 98 (77.1%) were identified as key barriers to pharmaceutical care provision. Among facilitators, private consultation areas for pharmacist 116 (91%), strong physician-pharmacist collaboration 121 (95.2%) and pharmacist participation in medical rounds 80 (63.0%) were found to be associated with pharmaceutical care provision. This study highlights the growing emphasis on pharmaceutical care, along with identifying areas that require improvement in tertiary healthcare settings in Pakistan.