Of the 120 questionnaires administered to the community pharmacists, 110 were retrieved representing a response rate of 91.7%.
Demographic characteristics of community pharmacists
25% of the respondents were females and 75% were males. The number of years of practice ranged from 1-5 years (50%), 6-10 years (41%) and over 10 years (9%).
Existing role of community pharmacists
65% of respondents did not play any role in the management of mental health illness. However with regard to the 35% who did, the highest proportion (57%) was involved with counseling associated with dispensing of medicines to psychiatric patients (Table ).
Roles of community pharmacists in the management of mental illness
Community pharmacists' knowledge of psychotropic medicines
Seventy nine percent (79%) of respondents rated their knowledge on psychotropic medicines as average, 2% as good and 19% as poor. The main reason cited for a less than good rating was inadequate education in the area of mental health (Table ).
Reasons cited by community pharmacists for rating knowledge of psychotropic medicines as average or poor
Views of community pharmacists on regular workshops
All the respondents said regular workshops would help improve their involvement in mental healthcare delivery. Workshops could cover signs and symptoms of mental illness (65% of respondents), counseling (96%), psychotropic medicines (79%) and current treatment regimens for mental illness (86%).
Barriers hindering community pharmacists' involvement
Perceived barriers that hindered the community pharmacist's involvement in the management of mental health included inadequate knowledge in the area (cited by 81% of respondents), low level of encounter with mental patients (72%), poor remuneration (56%), stigmatization of patients and personnel in the field (59%) and inadequate funding of services (51%).
Role of hospital pharmacists' on patient admission
The two respondents said they played a role on patient admission:
"On admission we check for the appropriateness of any prescribed drugs, relating to the dose- and interaction with other medication when the prescription is brought to the pharmacy." (H1)
"On admission, we dispense any drugs needed and help in stabilizing agitated patients by providing sedatives." (H2)
However, there was hardly any encounter between pharmacists and patients, or pharmacists and carers during admission; for medicine use review, counseling and monitoring of therapy:
"... admission is mostly done at the records department so we do not get to meet the carers. Also, most often, the nurses come here for all the patients' medications."(H1)
"We do not do much drug history taking or review here..." (H2)
Although the pharmacists did not see the carers or patients on admission, they were of the opinion that it was important for them to do so:
"...it could afford us the opportunity to counsel carers on the medication of the patient and it could also help us to know our patients better." (H1)
"It could help to foster good relations between the pharmacist and the carers of the patients..."(H2)
Role of hospital pharmacists during ward rounds
Respondents reported that they seldom conducted ward rounds and when they did, they did not go with other members of the healthcare team. One respondent cited his inadequate knowledge in psychiatry as a reason why he did not go on ward rounds with other members of the healthcare team:
"Well, on my part, I do not normally go for ward rounds due to my limited knowledge in psychiatry. You know in school we are not taught much of psychiatric conditions and this would make contributions during ward rounds difficult."(H1)
The other respondent explained that when she joined the hospital there was no structured ward rounds with other members of the healthcare team,
"... that is what is done here. I came to meet that here." (H2)
Role of hospital pharmacists during discharge of patients
Both respondents reported that they did not play a meaningful role during the discharge of patients.
"When a patient is discharged, usually the nurses come here for their drugs instead of their carers. So we counsel the nurses on how the patients should take their medication and hope they pass it on to the carers or the patients themselves." (H1)
"Ideally, we should have followed up on patients after discharge but this is not done here because there are community mental health nurses who provide primary care to discharged patients at the community level. However, we sometimes help in determining the time a discharged patient should come for review." (H2)
Hospital pharmacists' views on formation of medication education groups
It was apparent from the interviews that the respondents had mixed feelings about the formation of such groups, though they generally endorsed the view that if well-formed, the groups could help improve drug compliance.
"Yes because if properly done, it could help to educate patients on their medication, especially on issues of drug compliance by letting them know why they take their drugs. On the other hand, I would say no, because most of these patients have communication problems. Some do not know what they are talking about and others even do not understand what is said to them. Educating such a group will be very difficult if not impossible." (H1)
"No, because most of the patients we have here are not literate. Most of them even attach superstitious beliefs to their illness. This will make communicating with them very difficult and I wonder how it could help in their drug therapy since most do not believe in the drugs anyway." (H2)