The Provision of Pharmaceutical Care in Oman: Practice and Perceived Facilitators and Barriers to Implementation

Objectives: The study purpose was to determine the extent of the implementation of pharmaceutical care (PC) in Oman and factors affecting its implementation. Methods: A cross-sectional mail survey of all practicing pharmacists in Oman based on the Theory of Planned Behavior (TPB) was conducted. The survey instrument was informed by a focus group study to identify behavioral, normative, and control beliefs amongst pharmacists in three practice settings. Results: The survey useable response rate was 61.2%. Participants provided PC activities between `sometimes' and `most of the time'; however, provision of advanced PC activities was limited. Provision of PC did not significantly differ across inpatient, outpatient, and community settings. Clinical knowledge, communication skills, pharmacist time, and adequate staffing were common facilitators across practice settings; worry about responsibility and culturally-based gender issues regarding patient care were common barriers. While having a private counseling area, and access to patient records and to drug information databases were facilitators identified in the public sector, their absence was a barrier in community pharmacies. Reimbursement was the main barrier in the private sector. Country of origin was significantly related to pharmacists' beliefs about providing PC; specifically, Omani pharmacists had significantly different behavioral, normative, and control beliefs than their South Asian counterparts. All constructs of the TPB (attitude, subjective norm, and perceived behavioral control) were significant predictors of intention to provide PC, but the added construct--past behavior recency was not. The overall variance explained in intention was 43%. Of the two predictors of behavior in the TPB model, only perceived behavioral control was significant; intention was not. The explained variance in PC behavior was 13.0%. Conclusions: This is the first study to examine the implementation of PC in Oman. The findings of this study will inform the development of strategies for advancing PC practice, a mandate of Ministry of Health and the pharmacy profession in Oman. The TPB was useful for explaining pharmacists' intention to provide PC; however, a longitudinal study is recommended to test its predictive validity for PC behavior.Ph.D