Extemporaneous dispensing: opinions of Victorian community pharmacists

Objectives: To determine estimates of the type and extent of extemporaneous dispensing undertaken by Victorian community pharmacists and to analyse their views on related issues. Study Procedure: After telephone contact, a survey was mailed to every third community pharmacy in Victoria (n=420). Results: Completed surveys were received from 296 premises (70.5%). 1. Sample: 71% male; 61% sole/partner proprietor; 35% PhC and 67% BPharm graduates. 2. Extent: 60% dispensed 1-5 extemporaneous prescriptions per week (excluding water reconstitutions); for 75% of the sample, extemporaneous prescriptions made up < 1% of total prescriptions. 3. Preparation: 63% rated the adequacy of the range of ingredients as high or very high, 52% and 10% stated that the prescriber was often or very often a dermatologist and general practitioner, respectively. 4. Demand for service: 72% felt that extemporaneous prescribing had decreased or greatly decreased in the past five years, and 74% felt it would decrease or greatly decrease in the future. 5. Pharmacist confidence and satisfaction: 68% had high or very high confidence in their extemporaneous dispensing ability and 60% had high or very high satisfaction. 6. Factors influencing attitudes: high or very high on the list were time constraints for 35%; lack of stability data for 20%; and unknown efficacy for 20%. 7. Proposals for future: 75% agreed or strongly agreed that extemporaneous dispensing should remain one of the tasks undertaken by all pharmacists, 3% agreed or strongly agreed to forgo for all, and 13% agreed or strongly agreed to specialisation. 8. Skill level (since registration): 45% felt it was at the same level. 9. Need for refresher course: 21% felt it would be useful or very useful for them. Conclusions: Even though extemporaneous dispensing forms a minor part of community pharmacy business, most pharmacists strongly believed that it should be retained by the profession generally. Main concerns revolved around time constraints for undertaking the task and lack of stability and efficacy information. Most pharmacists reported that their levels of skill and preparation were of a high order. However, there were some areas for improvement, particularly relating to raw materials handling and equipment maintenance. It is recommended that comprehensive self-audits and update courses are implemented for quality assurance of dispensed products. (author abstract)