EXPLORING PHARMACISTS’ ROLES AND BARRIERS IN PUBLIC HEALTH CENTERS DURING THE COVID-19 PANDEMIC: A QUALITATIVE STUDY

Dewi Latifatul Ilma; Laksmi Maharani; Yulia Anggraini; Nia Kurnia Sholihat; Ika  Mustikaningtias; Tunggul Adi Purwonugroho

doi:10.37268/mjphm/vol.22/no.3/art.1713

Dewi Latifatul Ilma Department of Pharmacy, Faculty of Health Sciences, Jenderal Soedirman University, Indonesia
Laksmi Maharani Department of Pharmacy, Faculty of Health Sciences, Jenderal Soedirman University, Indonesia
Yulia Anggraini Department of Pharmacy, Faculty of Health Sciences, Jenderal Soedirman University, Indonesia
Nia Kurnia Sholihat Department of Pharmacy, Faculty of Health Sciences, Jenderal Soedirman University, Indonesia
Ika Mustikaningtias Department of Pharmacy, Faculty of Health Sciences, Jenderal Soedirman University, Indonesia
Tunggul Adi Purwonugroho Department of Pharmacy, Faculty of Health Sciences, Jenderal Soedirman University, Indonesia

DOI: https://doi.org/10.37268/mjphm/vol.22/no.3/art.1713

Keywords: Roles; Barriers; Pharmacist; Public health centers; the COVID-19

Abstract

The coronavirus disease 2019 (COVID-19) pandemic had a tremendous effect on essential healthcare services, including public health centers (PHCs). Pharmacists had the responsibility of maintaining high-quality pharmacy services during this pandemic. The objective of this study was to explore pharmacists’ roles and barriers in PHCs while providing pharmacy services during the COVID-19 pandemic. This study used a qualitative design with a phenomenological approach. Ten pharmacists from PHCs in Indonesia were recruited using a non-probability sampling method and interviewed individually using an online platform (Zoom and Google Meet) or via telephone. Informants were purposefully recruited through recommendations by registered pharmacists in Indonesia. Two interviews were conducted for each informant with an interval of 1 month. Each interview was recorded, transcribed verbatim, and analyzed using an inductive thematic method. Member-checking and peer-debriefing were conducted to increase the credibility of the study. This study revealed changes in the managerial and clinical pharmacy aspects of pharmacists’ roles. Additional roles related to COVID-19 were also described. In performing these services, pharmacists faced some barriers, including the limited provision of direct services to patients, a decrease in the number of patients, dishonesty among patients, a lack of human resources in PHCs, difficulty in procuring medical products related to COVID-19, and a lack of information regarding COVID-19 vaccination. The COVID-19 pandemic forced pharmacists in PHCs to adapt to various changes in pharmacy services, and support from stakeholders, including the government, patients, the pharmacists’ professional organization, and other health workers, is required to overcome the associated barriers.

References

WHO. Coronavirus 2020. 2020. https://www.who.int/health-topics/coronavirus#tab=tab_1 (accessed 4 Sep 2021)

Ministry of Health Republic of Indonesia. Pedoman Pencegahan dan Pengendalian COVID-19 Revisi Ke-5 (Guidelines for Prevention and Control of COVID-19 5th Revision). Jakarta: Ministry of Health Republic of Indonesia; 2020.

WHO. WHO Coronavirus (COVID-19) Dashboard. 2021. https://covid19.who.int/(accessed 25 Jan 2021]

OECD. Strengthening the frontline: How primary health care helps health systems adapt during the COVID 19 pandemic. OECD Publishing. 2021;(February):1–22. https://www.oecd-ilibrary.org/social-issues-migration-health/strengthening-the-frontline-how-primary-health-care-helps-health-systems-adapt-during-the-covid-19-pandemic_9a5ae6da-en

Ministry of Health Republic of Indonesia. Petunjuk Teknis Pelayanan Puskesmas Selama Pandemi COVID-19 (Technical Instructions for Public Health Center Services During the Covid-19 Pandemic). 2nd ed. 2021. 1–124 p.

WHO. COVID-19 continues to disrupt essential health services in 90% of countries. 2021. Available from: https://www.who.int/news/item/23-04-2021-covid-19-continues-to-disrupt-essential-health-services-in-90-of-countries (accessed 4 Sep 2021).

Ministry of Health Republic of Indonesia. Data Dasar Puskesmas (Public Health Centers Basic Data). 2021. https://pusdatin.kemkes.go.id/folder/view/01/structure-data-dasar-puskesmas.html (accessed 4 Sep 2021).

Ministry of Health Republic of Indonesia. Peraturan Menteri Kesehatan Republik Indonesia Nomor 43 tahun 2019 tentang Pusat Kesehatan Masyarakat (Regulation of the Minister of Health of the Republic of Indonesia Number 43 of 2019 regarding Public Health Centers). Ministry of Health Republic of Indonesia; 2019.

Melvin SC, Wiggins C, Burse N, Thompson E, Monger M. The Role of Public Health in COVID-19 Emergency Response Efforts From a Rural Health Perspective. Prev Chronic Dis. 2020;17:200256.

Rhatomy S, Prasetyo TE. Impact of COVID-19 on primary care visits: lesson learnt from the early pandemic period. Journal of Community Empowerment for Health. 2020;3(2):102–17.

Mukattash TL, Jarab AS, Mukattash I, Nusair MB, Farha RA, Bisharat M, et al. Pharmacists’ perception of their role during covid-19: A qualitative content analysis of posts on facebook pharmacy groups in jordan. Pharm Pract (Granada). 2020;18(3):1–6.

Merks P, Jakubowska M, Drelich E, Damian Ś. The legal extension of the role of pharmacists in light of the COVID-19 global pandemic. Research in Social and Administrative Pharmacy. 2021;17(1):1807-12.

Visacri MB, Figueiredo IV, Lima T de M. Role of pharmacist during the COVID-19 pandemic: A scoping review. Research in Social and Administrative Pharmacy. 2021;17(1):1799-1806.

International Pharmaceutical Federation. Coronavirus SARS-CoV-2/COVID-19 Pandemic: information and interim guidelines for pharmacists and the pharmacy workforce. FIP; 2020.

Basheti IA, Nassar R, Barakat M, Alqudah R, Abufarha R, Mukattash TL, et al. Pharmacists’ readiness to deal with the coronavirus pandemic: Assessing awareness and perception of roles. Research in Social and Administrative Pharmacy. 2021;17(3):514-22.

Cheong MWL. “To be or not to be in the ward”: The impact of COVID-19 on the role of hospital-based clinical pharmacists—A qualitative study. Journal of the American College of Clinical Pharmacy. 2020;3(8):1458–63.

Paudyal V, Cadogan C, Fialov D, Okuyan B, Lutters M, Stewart D. Provision of clinical pharmacy services during the COVID-19 pandemic: Experiences of pharmacists from 16 European countries. Research in Social and Administrative Pharmacy. 2020;17:1507–17.

Kasahun GG, Kahsay GM, Asayehegn AT, Demoz GT, Desta DM, Gebretekle GB. Pharmacy preparedness and response for the prevention and control of coronavirus disease (COVID-19) in Aksum, Ethiopia; A qualitative exploration. BMC Health Serv Res. 2020;20(913):1–6.

Ministry of Health Republic of Indonesia. Peraturan Menteri Kesehatan Republik Indonesia Nomor 74 Tahun 2016 Tentang Standar Pelayanan Kefarmasian Di Puskesmas (Regulation of the Minister of Health of the Republic of Indonesia Number 74 of 2016 regarding Standards for Pharmaceutical Services in PHCs). Jakarta: Ministry of Health Republic of Indonesia; 2016. p. 1–47.

Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care. 2007;19(6):349–57.

Creswell JW, Creswell JD. Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. 5th Edition. California: Sage Publication; 2018.

Nowell LS, Norris JM, White DE, Moules NJ. Thematic Analysis: Striving to Meet the Trustworthiness Criteria. Int J Qual Methods. 2017;16(1):1–13.

Ministry of Health Republic of Indonesia. Data Tenaga Kefarmasian yang didayagunakan di Fasilitas Pelayanan Kesehatan di Indonesia (Data on Pharmacy Workers in Health Service Facilities in Indonesia). 2020. http://bppsdmk.kemkes.go.id/info_sdmk/info/index?rumpun=105 (accessed 12 Aug 2021)

Muhammad K, Saqlain M, Muhammad G, Hamdard A, Naveed M, Butt MH, et al. Knowledge, attitude, and practices (KAPs) of Community pharmacists regarding COVID-19: A cross-sectional survey in two provinces of Pakistan. Disaster Med Public Health Prep. 2021;16:1-9

Bukhari N, Rasheed H, Nayyer B, Babar Z ud din. Pharmacists at frontline beating the COVID-19 pandemic. J Pharm Policy Pract. 2020;13(8):1–4.

Kristina SA, Herliana N, Hanifah S. The perception of role and responsibilities during covid-19 pandemic: A survey from indonesian pharmacists. International Journal of Pharmaceutical Research. 2020;12(2):3034–9.

Rajamani A, Subramaniam A, Shekar K, Haji J, Luo J, Bihari S, et al. Personal protective equipment preparedness in Asia-Paci fi c intensive care units during the coronavirus disease 2019 pandemic : A multinational survey. Australian Crirical Care. 2020;34(January):135–41.

Ministry of Health Republic of Indonesia. Keputusan Menteri Kesehatan Republik Indonesia No.HK 01.07/MENKES/5671/2021 Tentang Manajemen Klinis Tata Laksana COVID-19 di Fasilitas Pelayanan Kesehatan (Decree of the Minister of Health of the Republic of Indonesia No.HK 01.07/MENKES/5671/2021 regarding clinical management of Covid-19 in Healthcare Facilities). Jakarta: Ministry of Health Republic of Indonesia; 2021. p. 1–106.

Durand C, Douriez E, Chappuis A, Poulain F, Yazdanpanah Y, Lariven S, et al. Contributions and challenges of community pharmacists during the COVID-19 pandemic: a qualitative study. J Pharm Policy Pract. 2022 Dec 1;15(1):1–7.

Monaghesh E, Hajizadeh A. The role of telehealth during COVID-19 outbreak: A systematic review based on current evidence. 2020;20(1193):1–9.

Elbeddini A, Yeats A. Pharmacist intervention amid the coronavirus disease 2019 (COVID-19) pandemic: From direct patient care to telemedicine. J Pharm Policy Pract. 2020;13(1):1–4.

World Bank. Data for Lower middle income, Indonesia. 2021. https://data.worldbank.org/?locations=XN-ID (accessed 29 Aug 2021)

Keesra S, Jonas A, Schulman K. COVID-19 and Health Care’s Digital Revolution. New England Journal of Medicine. 2020;382(23):e82(1-3).

Shiferaw KB, Mengiste SA, Gullslett MK, Zeleke AA, Tilahun B, Tebeje T, et al. Healthcare providers’ acceptance of telemedicine and preference of modalities during COVID-19 pandemics in a low-resource setting: An extended UTAUT model. PLoS One. 2021;16(4):e0250220.

Strand MA, Bratberg J, Eukel H, Hardy M, Williams C. Community Pharmacists’ Contributions to Disease Management During the COVID-19 Pandemic. Prev Chronic Dis. 2020;17(200317).

Ministry of Health Republic of Indonesia. Peraturan Menteri Kesehatan Republic Indonesia No. 84 tahun 2020 tentang Pelaksanaan Vaksinasi dalam Rangka Penanggulangan Pandemi COVID-19 (Regulation of the Minister of Health of the Republic of Indonesia No. 84 of 2020 regarding the Implementation of Vaccination in the Context of Mitigating the COVID-19 Pandemic). Jakarta: Ministry of Health Republic of Indonesia; 2020.

Poudel A, Lau ETL, Deldot M, Campbell C, Waite NM, Nissen LM. Pharmacist role in vaccination: Evidence and challenges. Vaccine. 2019;37(40):5939–45.

Rhodes L, Williams D, Marciniak M, Weber D. Community pharmacists as vaccine providers. International Journal of Health Governance. 2017;22(3):167–82.

O’Connor AM, Evans AD. Dishonesty during a pandemic: The concealment of COVID-19 information. J Health Psychol. 2020;27(1):1–10.

Missel M, Bernild C, Christensen SW, Dagyaran I, Berg SK. It’s Not Just a Virus! Lived Experiences of People Diagnosed With COVID-19 Infection in Denmark. Qual Health Res. 2021;31(5):822–34.

Fisk RJ. Barriers to vaccination for coronavirus disease 2019 (COVID-19) control: experience from the United States. Global Health Journal. 2021;5(1):51–5.