Canadian Pharmacists Journal - May/June 2019 - 201

Original Research
were taking large numbers of medications.
There were a variety of reasons cited for
this, including significant time required
to complete the assessment, inadequate
compensation and lack of experience and
confidence in managing complex patients.
Respondents suggested creating a referralbased system of pharmacists who could
help them manage these patients.
Theme 9: Respondents felt that there was a
lack of physician and patient awareness
and understanding of the purpose and
the benefits of the SMAP. Respondents
believed that physicians and patients
would be more receptive of the SMAP if
they had a better understanding of the
program and what it was meant to accomplish.
Comparison of early and late respondents
When responses to the Likert scale questions
were compared between early and late responders, there were no differences identified, with
significance set at p < 0.05. In addition, there
were no differences identified between the
demographic characteristics of the early and late
responders.

Discussion

This study identified that community pharmacists in Saskatchewan who participated in the
survey perceive that the Saskatchewan Medication Assessment Program is achieving all of its
intended purposes. These perceptions are subjective and were not based on any objective findings, but it is nevertheless comforting to know
that the health professionals who are delivering
a service are able to observe its value and impact.
This study also found that the majority of participants were positive about this medication
assessment program. Most participants reported
that they enjoy performing the service and are
confident about their ability to provide a highquality service. This is noteworthy because previous studies have found pharmacist confidence/
skills and pharmacist apathy to be barriers to
practice change.20,21
This study also identified several opportunities for improvement of the SMAP. Incorporating both the quantitative and qualitative data
from this study, the following recommendations
are proposed:
C P J / R P C * M ay / J u n e 2 0 1 9 * V O L 1 5 2 , N O 3

1. Evaluate the program to determine the
impact on patient outcomes and patient
satisfaction.
2. Revise the documentation forms to be
more practical and user-friendly.
3. Communicate with physicians to highlight
the value of the SMAP and to encourage
interprofessional collaboration.
4. Provide ongoing continuing professional
development opportunities to support
pharmacists who are providing the
SMAP.
5. Evaluate SMAP government reimbursement eligibility criteria to ensure the program is accessible to patients who need it
the most.
6. Continue to improve pharmacist access to
electronic health records.
7. Create a referral-based system to assist
pharmacists in managing highly complex
patients.
Some of these recommendations are also potentially relevant in jurisdictions outside of Saskatchewan. For example, the recommendation
to expand the government reimbursement eligibility criteria to include additional high-risk
groups has been identified as an issue in other
studies, suggesting that this is not just a barrier to the medication assessment program in
Saskatchewan.13,22
The results of this study also identified an
interesting dichotomy between pharmacists'
perceptions of the SMAP in the Likert scale
questions, which were mostly positive, confident and optimistic, and the free-text responses,
which focused on aspects of the program that
need to be improved. It may appear to be a
contradiction that the majority of respondents
enjoyed performing assessments, were confident
in finding problems and believed that the SMAP
was achieving all of its intended purposes,
despite the many barriers identified in the freetext responses. However, a possible explanation
for this apparent contradiction is that Saskatchewan pharmacists are successfully providing
this service despite the many barriers that they
experience.
Pharmacists have previously been accused of
using the commonly reported barriers to practice change as an excuse for inaction and apathy.20 Perhaps Canadian pharmacy practice has
now reached the tipping point where this apathy
201

Canadian Pharmacists Journal - May/June 2019

Table of Contents for the Digital Edition of Canadian Pharmacists Journal - May/June 2019