The study evaluated the knowledge, attitude, and practice of pharmacists in community pharmacies regarding EBM and its application in serving pharmacy clients. This study used a valid questionnaire designed by an expert panel and an SPM to evaluate pharmacists' practices and attitudes.
According to previous studies, patients with more knowledge about the medication or supplement they plan to use are more likely to consume it correctly (24, 25). In this regard, the pharmacist's role as a healthcare provider includes explaining important information to patients about medication use and instructions, which can positively impact public health. The study uncovered that pharmacists lack enough knowledge about available resources due to insufficient time for searching and studying valid and new publications. Additionally, pharmacists reported a lack of time to use these resources in community pharmacies. A challenge in implementing EBM is that more knowledge and skills are required to find and use reliable evidence. This problem is often exacerbated by inadequate training and the ability to integrate current and reliable evidence into clinical practice. Although pharmacists generally have a positive attitude towards EBM in pharmacy practice, it is evident that many of them do not use electronic information databases and have limited knowledge about them.
The study conducted by Sahebalzamani et al. found that the level of knowledge of clinical assistants about EBM was moderate, and the ability of EBM utilization was undesirable (26). Another study by Bahammam et al. discovered that students had insufficient knowledge about EBM, and there was no significant disparity between medical and dental students (27). A 2019 study conducted by Xi et al. revealed several concerning issues in community pharmacies. Insufficient physical space, delayed presentation of pharmacy rules, patient non-adherence to medical care, and a lack of effective communication with patients were some of the main challenges. This research emphasizes the pressing necessity to tackle these obstacles and enhance community pharmacies' overall standard of care. These reasons interfere with providing patients with an efficient pharmacist counseling package (28).
Suppose we want to explain the relationship between age and pharmacists' knowledge. Pharmacists' knowledge and familiarity with resources for addressing patients' medication needs have declined or remained the same as they get older. Younger pharmacists increasingly benefit from advanced scientific knowledge and readily available information through reputable databases and references. However, older pharmacists face challenges like time constraints, inadequate facilities, and limited opportunities for ongoing training. As a result, their knowledge and skills may gradually decline.
In this study, an extremely high percentage of pharmacists have a Pharm. D, and there was a bachelor alumnus in some age groups. No statistically significant difference was observed between the education and knowledge within the mentioned groups. In addition, most pharmacists had less than five years of work experience. Surprisingly, no correlation was found between the knowledge levels and work experience of pharmacists with over 30 years of work experience compared to other groups. However, young and less experienced pharmacists demonstrated greater knowledge and clinical management proficiency.
The present study reveals that most pharmacists possess a poor to moderate grasp of EBM, and their practice reflects this. However, pharmacists demonstrated a positive attitude but lacked understanding of effectively implementing EBM into practice. This finding is in accordance with the study conducted by Qharibi et al., highlighting the numerous challenges of applying successful primary health care programs in Iran (29).
Using online resources and electronic databases like UpToDate® helped pharmacists enhance their knowledge scores and make better decisions. This finding implies that utilizing these valuable resources can bridge the gap between the attitude and actual implementation of EBM in community pharmacies. Solutions to address these pharmacy practice challenges include:
-
Increasing the number and the quality of retraining courses,
-
Continuous training,
-
Establishing a regulatory framework,
-
Establishing a relationship between the provisions of medical services and increasing the income of pharmacists.
This study had limitations in collecting and reporting relevant information that could impact the survey results. The limitations include the absence of pharmacists in certain pharmacies, an uneven distribution of selected pharmacies in Tehran, overcrowding, and difficulties in scheduling interviews with pharmacists.