Patient–Pharmacist Interaction in Ethiopia: Systematic Review of Barriers to Communication

Figures & data

Figure 1 Data search process.

Table 1 Detailed Descriptions of Study Characteristics

Sr no	Author	Study Area	Study Design	Subjects	Sampling Technique	Sample Size	Year
1	Ayalew E, Seid Y, AgaluA^Citation16	Mekelle	Institutional and community based cross-sectional	Pharmacy professionals	None	49	2012
2	Nigussie WD^Citation17	Bahir dar	Institutional and community based cross-sectional	Pharmacy professionals	Systematic random sampling	400	2014
3	Surur et al^Citation18	Gonder	Community based cross-sectional and simulated patient study	Pharmacy professionals	Simple random sampling	78	2016
4	Nigussie S and EdessaD^Citation19	Harer	Institution based cross-sectional	Patient	Simple random sampling	844	2018
5	Hirko N, Edessa D, SisayM^Citation20	Harer	Institution based cross-sectional	Patient	Convenience	422	2016
6	Wadoa TE, Gunasekarana T, Dhanaraju MD^Citation21	Adama	Institution based cross-sectional	Pharmacy professionals and patient	Simple random sampling	345	2014
7	Hirko N, EdessaD^Citation5	Harer	Community based cross-sectional	Patient	Convenience	422	2016
8	TayeY^Citation22	Addis Abeba	Community based cross-sectional	Patient	Convenience	374	2018
9	Wabe NT, Raju N, Angamo MT^Citation23	Gondar and Bahir Dar	Institutional and community based cross-sectional	Pharmacy professionals	None	64	2009
10	Ali S, Shimels T, Bilal AI^Citation24	Addis Abeba	Institution based cross-sectional	Patient	Convenience	286	2018
11	Diriba G, Alemkere G, GedamuM^Citation25	Nekemet	Institution based cross-sectional	Patient	Simple random sampling	398	2017
12	Gelayee DA, Birara MK^Citation26	Gonder	Institutional and community based cross-sectional	Pharmacy professionals	None	63	2011
13	Belay et al^Citation27	Mekelle	Institution based cross-sectional	Pharmacy professionals	None	100	2016

Table 2 Pharmacy Professionals’ Barriers to Communication

Sr no	Author	Barriers to Patient–Pharmacist Interaction
1	Ayalew E, Seid Y, AgaluA^Citation16	Lack of knowledge (65.31%)
2	Nigussie WD^Citation17	Lack of knowledge on drugs (76.7%), lack of updated drug information (90%), Dispenser work experiences (AOR = 2.99) and average consultation time (AOR=3.42) were associated factors for satisfactory counseling.
3	Surur et al^Citation18	Limited knowledge about drugs (65.4%), lack of up-to-date drug information (39.7%), being unhappy with the task (66.2%), lack of good communication skills (60.5%) and shortage of time (33.8%)
4	Nigussie S and EdessaD^Citation19	Respect for patient (66.2) and time given for filling prescription (71.4). Patients’ perceived insufficient knowledge of pharmacists (AOR=2.50) was determinant of dissatisfaction.
5	Hirko N, Edessa D, SisayM^Citation20	Perceived poor communication (7.1%), not clear ascent of the dispenser (12.8%), impoliteness of the dispenser (6.4%), non-clarity of the dispenser’s guidance (9.2%) and insufficiency of the dispenser’ information (27.3%)
6	Hirko N, EdessaD^Citation5	Clearness of pharmacist’s voice and tone (16.6%), impoliteness of service provider (5.90%), non-clarity of the pharmacist’s instruction to patient (8.8%) and insufficiency of pharmacist’s knowledge (11.6%)
7	TayeY^Citation22	Pharmacists‘ communication skills (β= 0.44), pharmacists’ empathy (β= 0.07), provision of instruction on usage of medicines (β= 0.15) and provision of information on disease condition (β= 0.23) were determinants of satisfactory counseling.
8	Wabe NT, Raju N, Angamo MT^Citation23	Lack of knowledge (43.8%)
9	Ali S, Shimels T, Bilal AI^Citation24	Lack of updated drug information (91.5%) Educational qualification, knowledge and age had significant influence on counseling response (P<0.05)
10	Gelayee DA, Birara MK^Citation26	Lack of knowledge of practitioners (80.96%), lack of time of practitioners (7.94%) and lack of interest of practitioners (7.94%)
11	Belay et al^Citation27	Lack of knowledge of practitioners (37%), lack of updated drug information (49%), poor communication (52%), lack of confidence (25%), lack of interest (30%), lack of experience (30%), poor attitude (25%) and not considering it as part of professional duties (26%)

Figure 2 Frequency of pharmacy professionals’ related barriers to communication.

Table 3 Patient Barriers to Communication

Sr no	Author	Barriers to Patient–Pharmacist Interaction
1	Ayalew E, Seid Y, AgaluA^Citation16	Lack of interest (63.27%)
2	Nigussie WD^Citation17	Patient factors (patients not wanting to talk much, patients’ low attitude toward pharmacy) (20%)
3	Surur et al^Citation18	Patient factors like illness, rush to leave and lack of willingness (12.8%)
4	Nigussie S and EdessaD^Citation19	Degree of satisfaction with pharmacy staff’s service (64.3%) Marital divorce (AOR=2.67) and good interaction with their pharmacists (AOR=0.28) were determinants of dissatisfaction.
5	Wadoa TE, Gunasekarana T, Dhanaraju MD^Citation21	Language and educational status of patient
6	Wabe NT, Raju N, Angamo MT^Citation23	Patient factors (patients not wanting to talk much, patients’ bad attitude toward pharmacy) (18.8%)
7	Ali S, Shimels T, Bilal AI^Citation24	Patient related factors (either lack of patience to listen the counseling provided or poor attitude toward pharmacy services) (33.3%)
8	Diriba G, Alemkere G, GedamuM^Citation25	Age (P value=0.000), educational status (P value=0.000), sex (P value=0.002) and residence (P value=0.000) were associated with misunderstandings

Figure 3 Frequency of patients’ related barriers to communication.

Table 4 Health Facility-Related Barriers to Communication

Sr no	Author	Barriers to Patient–Pharmacist Interaction
1	Ayalew E, Seid Y, AgaluA^Citation16	High patient load (79.59%) and no legalization (8.16%)
2	Nigussie WD^Citation17	High patient load (70%) and absence of legal frame work to monitor and evaluate patient counseling practice at the time of dispensing (56.7%) Patient load (AOR = 2.87), level of health facility (AOR = 4.31) and type of health facilities (AOR = 4.29) were associated factors for satisfactory counseling.
3	Surur et al^Citation18	High patient load (29.5%)
4	Nigussie S and EdessaD^Citation19	Suitability of dispensing area (62.5%), privacy in dispensing area (41.2%), waiting time for service (74.6%), availability of prescribed drug (38.9) and location of outpatient pharmacy (62%), lack of quality system (AOR=13.56) were determinants of dissatisfaction.
5	Hirko N, Edessa D, SisayM^Citation20	Non-suitable waiting area (17.3%)
6	Hirko N, EdessaD^Citation5	Not comfortable waiting area (9.7%)
7	Wabe NT, Raju N, Angamo MT^Citation23	High patient load (29.7%) and no legalization (25%)
8	Ali S, Shimels T, Bilal AI^Citation24	Lack of space (21.4%), high patient load (23.8%) and no legalization (12%)
9	Gelayee DA, Birara MK^Citation26	Absence or inadequacy of counseling guidelines (3.17%)
10	Belay et al^Citation27	High patient load (62%) and absence of private counseling room (51%)

Figure 4 Frequency of health facility-related barriers to communication.

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