The common since the Estonians patients prefer

     The term
“Pharmaceutical care” has been discussed for decades now, and has
been incorporated into the curricula of every pharmacy school as well as the
profession in general.  The concept of
pharmaceutical care in its modern sense was introduced in 1980 and defined as
“pharmaceutical care includes the determination of the drug needs for a given
individual and the provision not only of the drug required but also the
necessary services (before, during or after treatment) to assure optimally safe
and effective therapy” (Hepler, 2004).

     In 1989,
Hepler and his colleague Strand introduced a definition that emphasized the
importance of pharmaceutical care outcomes. They defined the pharmaceutical
care as “Responsible provision of drug therapy for the purpose of achieving
definite outcomes that improve a patient’s quality of life” (Al-Quteimat and
Amer, 2016). The statement
of ASHP on pharmaceutical care (1998) stated that
pharmaceutical care involves three major functions; identifying potential and
actual DRPs, solving the Actual DRPs and preventing potential DRPs.

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      Currently, the concept of pharmaceutical care has influenced the practice of many
community pharmacies across the world (Mazhar et al., 2017). shifting the practice scope away from the traditional roles such
as medication dispensing, towards offering services that aim to improve both
health care outcomes and patients’ life quality, such as minor ailment
prescribing, medication reviews, immunizations and strategies to encourage
medication adherence (Kelly et al., 2014).

      Every country
provides different type of services according to their patients’ needs for such
services or the government legislation in the Country. in Germany, many services were
offered by the pharmacists, including dispensing medications, consulting
patients on how to deal with minor ailments, screening services for diseases
like D.M, osteoporosis, hypertension and dyslipidemia (Eickhoff and  Schulz, 2006).

     In spite of the Portuguese legislation is clear about the
dispensing process of medication and duties of the pharmacists but when it
comes to the expanded services or pharmaceutical care services there is no
reference made to regulate such services. Nevertheless, Portuguese pharmacists
have implemented various services to their patients including TG-measurements,
drug disposal management and pharmacy-based disease management (costa et

      The Canadian community pharmacists are
more Cooperative with their patients by offering Home delivery
for prescriptions, Home visits, Patient call-back system and Out-of-store
educational programs (Jones et al.,2005).

the other hand, in Estonia providing recommendations about herbal medicine use
and the interaction of herbs with drugs is very common since the Estonians
patients prefer the herbal medicine over the prescribed medication to treat the
minor ailments which requires from the pharmacists to have a sufficient
knowledge in this filed ( al.,2008)

    Also, in Brazil services like Nebulization,
administration of injectable medication, capillary glucose test and bandaging
are provided in some states but like the Portuguese there is no clear national regulation to
such services. (Castro and Correr, 2007)

     In UK the community pharmacies services are
divided into two types (essential and advanced) essential services which is
provided by all the community pharmacies like dispensing of medication and
Enhanced services which the community pharmacies can choose to
provide any of these services like smoking cessation programs, medicine use review
and flu vaccination ( sadek et al.,2016)

       Locally, community pharmacies services
vary according to the location. In central cities like Jeddah and Riyadh
different type of services are provided ranging from dispensing medications to
screening services like measuring blood pressure, blood glucose and body mass
index. In comparison, the pharmacists in rural cities tend to provide only the
essential services (Al-Tannir et al.,2016; Al-Hassan ,2009).

     Despite the
expanding role of the community pharmacists, there appears to be a discrepancy
between the growing role of pharmacists and the actual practice of
pharmaceutical care in the community pharmacies. “Schommer et al (2006)”
conducted a study to examine the gap between the pharmacists’ beliefs and
practice, targeting pharmacists from a chain of community pharmacies in the US.
The results showed that the pharmacists wanted to spend 36% of their working
time in dispensing medications and 47.8% of their time to perform clinical
activities, but actually 55.2% of the working time was spent in dispensing
medications and only 26.9% of it to provide those clinical services (Maynard et al., 2011).


     Another Study conducted by National Pharmacist Workforce Survey
(2004) in the US that assessed both community
pharmacists’ services and their working environments, found that only 10-20% of the community
pharmacists provided at least one pharmacist care service at their practice
site, while 54.4% of the community pharmacists participated in the study did
not offer any of these services. A pharmacist care service was outlined by the
researchers as 8 different cognitive services, including smoking cessation
programs, health screenings, disease state management and immunizations (Maynard et al., 2011; Doucette et al,2006).

     In Finland The TIPPA (2000-2003) project was
initiated by Ministry of Social Affairs and Health with collaboration of
different universities and local committees to decrease consequences resulting
from irrational use of medications and enhancing the practitioners’ counseling
practice in the community pharmacies. The project aims to achieve a permanent
change in the communication behavior of community pharmacists by implementing a
development process consists of 4 phases: phase one aims
to increase the awareness among the practitioners by introducing new counseling
techniques and developing specific counseling tools and resources (e.g.
establishing a manual to guide the practitioners in counseling. Phase 2:
developing self-assessment instruments to ensure the quality of counseling
practice. Phase 3: encouraging the use of patients counseling resources and
evaluating the implementation of TIPPA resources. Phase 4:
evaluating, reporting, and processing a new national action plan (bell
et al.,2007).

     The Patients’ acceptance of healthcare
services that are provided by the healthcare professionals is affected by
either the communication skill of health care professionals or the cultural
perception of healthcare. It is probably that patients’ perception about the
pharmacist role is what will affect their decision whether they will seek
advice from the pharmacist or will use the pharmaceutical care services provided
in the community setting (Jose et al.,2015).

     A Qualitative
study was conducted by “Franic et al, (2008)”in Georgia and found that several
patients were unfamiliar with the concept of pharmaceutical care and different
type of services that are provided by their pharmacists. The researchers
suggested that the reason why the patients did not demand these services from
their pharmacists is simply because they were uninformed about pharmacists’
role in their health care.



     Another study
was performed by “Jose et al., (2015)”to assess Public’s perception about the roles
and services of community pharmacists in Sultanate of Oman, and they found that
the majority of the participants considered the pharmacist as an expert on
matter of drugs and he is able to provide services like pressure monitoring and
blood glucose measurement in the community setting.

      Also a Study conducted by “Perepelkin ,
(2011)”to evaluate the public opinion about the pharmacists and the prescribing
authority, found that the majority of participants showed a positive view of
pharmacy profession in general while the major factors influencing their choice
of community pharmacy services was the expertise of the pharmacist followed by
the communication skills of the pharmacist.

     In addition, Study was performed in Kuwait
by “Awad et al., (2017)” revealed that one third of the participants (n=433)
perceived the community pharmacists to be interested in both providing
healthcare services and making profit and Half of the participants did not
expect that the pharmacists’ role may include monitoring of health progress.

     Locally, a
study conducted at Riyadh by “Bawazir(2004)” to assess the consumer attitude
towered the services provided in community pharmacies showed that around half
of the participants (n=1144) perceive the pharmacists as just sellers who are concerned
more in making profit.

     Another study
by “Al-Arifi,(2012)” was conducted in Riyadh ,showed that about half of the patients participated in the study (n=
1699) were expecting the pharmacist to do more than just dispensing of
medications. With Only 37.3% of participants perceived pharmacists as
just sellers while 44.3% of them had a higher
expectation from the pharmacists as professional health care providers. Showing
that the image of pharmacy profession in Saudi Arabia is improving throughout
the years.

collecting these opinions and views about the pharmacists is necessary to
improve the current services, identifying the need of new services and
enhancing communication and expectations mutually (kucukarslan and

     The current
study aims to assess the perception of patients about the pharmaceutical care
services provided by community pharmacists in Al-qassim region, Saudi Arabia to
provide guiding information
for further improving of pharmaceutical care services in the community setting.