A community survey on knowledge, attitude and practice of pharmacy practice regulations among pharmacists in Kerala, Southern India

Abstract

Background: Paucity of Knowledge, Attitude and Practice (KAP) regarding pharmacy regulations in India is the underlying reason for non-recognition of Pharmacists as health care professionals.  Objectives: This study was aimed at assessing the Knowledge, Attitude and Practice (KAP) of community pharmacists towards the recently implemented regulations entitled Pharmacy Practice Regulations 2015 (PPR2015) with the help of brief counseling session on the recent PPR2015. Methodology: A 10 month long cross-sectional survey was conducted in selected areas of Northern Kerala, involving 450 community pharmacists registered under state pharmacy council.   A self-prepared and expert-validated Community Pharmacy Survey Questionnaire (CPSQ) was used for the base line survey spread over first four months. Counseling was provided upon completion of the survey. After 4 months, CPSQ was again used to trace the changes in KAP. Results: 150 community pharmacists each from Kozhikode, Malappuram and Thrissur districts were enrolled.  Licensed pharmacists (qualification: Diploma in Pharmacy) constituted most participants in the survey in all 3 districts - with Kozhikode (74.7%), Malappuram (76%) and Thrissur (60.7%). Knowledge scores in Malappuram district were found to be higher in the baseline survey (4.9). Attitude data showed Kozhikode pharmacists have a better attitude at baseline (4.9) compared to other two districts (4.3; 4.3), which improved after the brief presentation on PPR2015. Practice scores were consistent among all the three districts (15.3; 15.8; 15.0). Conclusion: The data with reference to knowledge and attitude contrasts heavily with data on practice. The study failed to observe any specific pattern of improvement in KAP. The heightened awareness among patients about the need for patient-oriented services is possibly creating a sense of insecurity among poorly trained/qualified community pharmacists. Since only the Pharm D curriculum is patient-oriented, the inconsistent results of the survey may be attributed to a prejudicial response bias among most community pharmacists with D Pharm, B Pharm and M Pharm qualifications, neither of which are patient-oriented.