Extended Pharmacy Services in Pakistani Community Pharmacies: A Cross-Sectional Assessment of Implementation Status,...

Extended pharmacy services (EPS) encompass comprehensive healthcare interventions beyond traditional medication dispensing, representing a paradigmatic shift toward patient-centered pharmaceutical care. While well-established internationally, EPS implementation remains limited in Pakistan due to regulatory gaps and insufficient public awareness. This study evaluated current EPS provision in Pakistani community pharmacies and identified key implementation barriers.

A cross-sectional mixed-methods survey was conducted between July toOctober 2024 in Karachi, Pakistan. Data collection utilized online and in-person questionnaires comprising 12 structured items addressing EPS knowledge, perceptions, and demographic characteristics among 220 community pharmacy professionals. The Questionnaire's reliability was validated using Cronbach's alpha coefficient (α = 0.705).

Among 220 respondents (127 pharmacists, 93 pharmacy technicians), Medication Therapy Management emerged as the most frequently offered extended service (45.5%). Primary implementation barriers included workload and time constraints (56.4%), insufficient staffing (44.1%), and medication shortages (47.3%). While 43.6% demonstrated EPS familiarity, 49.5% reported no specialized training. Most respondents perceived EPS as valuable healthcare additions (65.5%) and anticipated significant future expansion (58%).

Study findings reveal Pakistan's community pharmacy practice remains predominantly dispensing-focused despite growing recognition of expanded pharmacist roles nationwide. Barriers reflect significant systemic challenges requiring coordinated multisectoral interventions across regulatory, educational, and infrastructure domains to enable sustainable EPS implementation.

Extended pharmacy services present significant opportunities for Pakistani healthcare advancement but require comprehensive paradigmatic shifts through legal frameworks, enhanced professional training, and increased stakeholder awareness to successfully transform community pharmacists into fully recognized clinical healthcare providers nationwide.