Public perspectives towards extended community pharmacies services in Saudi Arabia: an online cross-sectional study

Background In many developed countries, the scope of community pharmacy services has extended to deliver more advanced applications. Unlike the traditional practice focusing on pharmaceutical sales, extended community pharmacy services (ECPSs) are patient-centred, typically offered by specialised healthcare centres, which improve public health, reduce pressure imposed on healthcare professionals and rationalise the health system expenditure. However, several studies have revealed that community pharmacies (CPs) provide only marginalised services. Therefore, a public review is crucial for effectively utilising such healthcare-complementary professional services. This study explores CPs utilisation among the Saudi public in terms of knowledge, attitudes, and barriers towards ECPSs. Materials and Methods A cross-sectional web-based survey of a non-probability sample was conducted between October and December 2021. Numerical and graphical descriptive statistics were employed with an additional analytical assessment using binary logistic regression for the association between characteristics of participants and barriers to utilising ECPSs. Results A total of 563 subjects participated, of which about 33% considered CPs the first place to visit if they have medication concerns. Most were unfamiliar with medication therapy management and health screening services (77%%, and 68%, respectively). Pharmacy clinics for receiving private counselling and electronic patients’ medical records were unknown facilities to them (79% and 63%, respectively). A substantial portion considered the lack of privacy (58%) and inadequate communication with the community pharmacists (56%) as key barriers. The logistic regression analysis revealed that the underdeveloped infrastructure of CPs was significantly associated with almost all factors. Privacy issues concerned females, highly educated and high-income individuals, and those with health insurance. In addition, low socio-economic status, subjects with special needs or chronic diseases, non-health insured and smokers were less likely to utilise the ECPSs due to economic reasons. Conclusions The most public was under-utilised services and facilities. Positive attitudes were associated with public concerns regarding their privacy and the cost of services. In line with the Saudi vision 2030, supporting CPs and increasing public awareness towards ECPSs will have significant public health implications. ### Competing Interest Statement The authors have declared that no competing interests exist. ### Funding Statement This study is a part of a PhD research project sponsored by Al Baha University, Saudi Arabia (Decision of Scholarship No: 40267573, July 2019). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Permission for conducting the study was obtained from the Ethical Research Committee at the Saudi Ministry of Health (MOH), Riyadh (Central IRB log No: 21-56E, June 2021). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All relevant data are within the manuscript and its Supporting Information files.