Globally over the few decades, the role of pharmacists has been recasting persistently to meet the fluctuating needs of society (1). Within the last decades, the role of the pharmacist and pharmacy practice has paradigmatically shifted from that of drug manufacturing and technical dispensing to a more cognitive role with patient orientation (2). An increase in health demand with a complex range of chronic medicines and poor adherence to prescribed medications forces the pharmacy profession to continue to move toward a patient-centered practice (3). Pharmacy students at university of Georgia taught pharmaceutical care (PC) as “the responsible provision of medication therapy for achieving outcomes that improve a patient’s quality of life and involves pharmacists working with patients and other health care professionals in designing, implementing, and monitoring a therapeutic plan for the purpose of achieving definite outcomes” (4). More recently, the Pharmaceutical Care Network Europe promulgated the definition of PC as “the pharmacist’s contribution to care of individuals in order to optimize medicines use and improve health outcomes” (5). Several studies revealed that implementing pharmaceutical care in health institutions has several advantages starting from effective utilization of pharmaceuticals to overall improvements which are related to adherence, compliance and health-related quality of life especially in diabetes (6), heart failure, asthma, hypertension, breast and ovarian cancer, cardiovascular diseases, asthma and chronic obstructive pulmonary diseases (5). Additionally studies done in the University of Gondar (7), Nigeria (8), Qatar (9), Pakistan (10), Cuban (11) and USA (4) revealed as students had a positive attitude toward pharmaceutical care. Further students also identified most perceived barriers that tackle the implementation of pharmaceutical care such as inadequate drug information sources, lack of access to patient information and workplace for counseling, time constraint, insufficient professional skills, poor image of the pharmacist, and economic incentive (5). Other studies also showed the earlier pharmacy students are exposed to actual patients; the more likely they are to develop pharmaceutical care skills and positive pharmaceutical care attitudes (12).
In Ethiopia, pharmacy school started 60 years back in Addis Ababa University with the vision to be the center of excellence in pharmaceutical education, research, and practice in Africa. Concerning initiation of clinical pharmacy, in March 2009, the School of Pharmacy of Jimma University launched the country's first graduate program in clinical pharmacy with the objective of training patient-centered pharmacy practitioners as well as training faculty members for the new undergraduate clinical pharmacy programs (13).
In many developed countries, the provision of PC is highly advocated but when we come to developing countries like Ethiopia even though students can acquire knowledge related to pharmaceutical care its applicability in practical settings is still in its infant age due to several reasons.
To date, there are no studies conducted in Addis Ababa University that assess student's attitudes toward pharmaceutical care and perceived barriers toward its provision, the findings of this study will help to identify the attitude of pharmacy students toward pharmaceutical and their perceptions about barriers that tackle its applicability in practical settings, which in turn helps institutional policymakers, pharmaceutical practitioners, researchers, the government, and the society in general to find solutions for the perceived barriers.
Pharmaceutical practitioners can use the information to operate an efficient and effective pharmaceutical practice with the reduction of adverse drug effects and achievement of positive therapeutic outcomes in patients.
Recognizing the global change in pharmaceutical care, various efforts have been made in Ethiopia to introduce clinical pharmacy services in the health care system. They include: revision of the undergraduate pharmacy curriculum in public universities in 2008; establishment of drug information center at Tikur Anbessa Specialized Hospital (TASH) in 2009 by Addis Ababa University School of Pharmacy with a technical support from Howard University College of Pharmacy and financial support from PEPFAR/CDC through the American International Health Alliance-Twinning Center; launching of the clinical pharmacy post-graduate program at Jimma University in 2009 and pharmacy practice postgraduate program at Addis Ababa University in 2010; inclusion of clinical pharmacy services as one operational standard in the Pharmacy chapter of the Ethiopian Hospital Reform Implementation Guidelines (EHRIG) by the Federal Ministry of Health (FMOH) in 2010 and inclusion of CPS as one standard in the health facilities minimum regulatory standards prepared by the Ethiopian Standards Agency (ESA), Ethiopian Food, Medicines and Health Care Administration and Control Authority (FMHACA) in 2012 (1).
Attitude of undergraduate pharmacy students toward the provision of pharmaceutical care
Over the few recent years, many pieces of research have been conducted to assess the attitude of pharmacy students toward pharmaceutical care in both developing and developed countries.
Qatar pharmacy students had a positive attitude toward the provision of PC. All respondents agreed that the primary responsibility of pharmacists in the health care setting should be to prevent and solve medication-related problems, that the practice of PC is valuable, and that the PC movement will improve patient health. However, 76% of respondents believed that providing PC takes too much time and effort (9).
According to a cross-sectional study conducted among Nepal undergraduate pharmacy students, more than 80% of the students agreed or strongly agreed that PC practice is the primary responsibility of the pharmacists (83.1%) and it should be practiced by all pharmacists (88.8%).
Nearly all the students agreed or strongly agreed that the practice of PC is valuable (94.8%) and the primary responsibility of pharmacists in the healthcare setting should be to prevent and solve medication-related problems (94%). The majority of the students expressed their interest in performing a PC as a pharmacist practitioner (87.1%) and considered it to be professionally rewarding (84.9%) or beneficial to their professional pharmacy career as a pharmacy practitioner (90.1%) (5).
Perceived barriers for implementation of pharmaceutical care
Studies conducted among Nepal among undergraduate pharmacy students revealed that the potential barriers to PC provision as perceived by the students were inadequate training in PC (75.9%), inadequate drug information resources in the pharmacy (73.3%), lack of access to the patient medical record in the pharmacy (71.1%) and lack of limited workspace in government and private hospitals (69.3%) were perceived as the main barriers to PC provision by most of the students (5).
According to a cross-sectional study conducted among final year, University of Gondar pharmacy students the barriers perceived highly by students as that prevented them from providing PC included lack of workplace for counseling in the pharmacy (75.4%), a poor image of pharmacist's role inwards (67.7%), inadequate technology in the pharmacy (64.6%), inadequate drug information resources in the pharmacy (53.8%), lack of access to patient medical records in the pharmacy (50.8%), and inadequate training in PC (50.8%) (7).