Assessing confidence of community pharmacists in inflammatory bowel disease management : a cross-sectional study in Malta

Abstract

Objectives: To evaluate community pharmacists’ confidence in the management of inflammatory bowel disease (IBD) and to identify areas in which pharmacist-led patient education and counselling could be strengthened. Methods: This cross-sectional study was conducted in three phases; questionnaire development and review by an expert panel, reliability assessment, and dissemination to 100 community pharmacies selected through stratified random sampling across Malta. Pharmacists’ confidence across 29 items was assessed using mean rating scores (MRS) on a 5-point Likert scale. Non-parametric analyses examined associations between confidence, demographic variables, and perceived barriers (P < .05 statistically significant). Key findings: Ninety-four pharmacists completed the questionnaire; female (n = 65), > 5 years of community pharmacy experience (n = 56), worked 31–40 hours weekly (n = 39), Master of Pharmacy degree (n = 47). ‘High’ confidence (MRS ≥4/5) was reported for advice on diet and lifestyle, non-prescription medicines for symptom management, medicine storage/stability, and recognizing when referral was required. ‘Moderate’ confidence (MRS 3 to <4/5) was observed for adherence support, relapse, counselling on extraintestinal complications, dosage form administration, corticosteroids, methotrexate, aminosalicylates, and biologics. ‘Low’ confidence (MRS <3/5) was identified for counselling on thiopurines, non-prescription medicines associated with toxic megacolon, vaccines, and pregnancy and women of child-bearing age. The main reported barriers to providing advice were time constraints (n = 70) and patient-related communication challenges (n = 63). Years of experience, hours of practice, and inadequate private consultation space were not significantly associated with pharmacist confidence (P > .05). Conclusions: Community pharmacists were more confident in general counselling and referral-related support than in medication-specific counselling and more complex aspects of IBD care.