Abstract
Aim: To evaluate self-perceived capabilities, opportunities, motivations and barriers among Australian community pharmacists to deliver knee osteoarthritis (OA) care aligned with the Australian Osteoarthritis of the Knee Clinical Care Standard quality statements.
Methods: Australian-registered and practicing community pharmacists were invited to complete an e-survey between Sept-2023 and Aug-2024, co-designed with industry partners, using the COM-B behavior change model. The survey assessed pharmacists' perceptions of the feasibility to deliver knee OA care, focusing on five of the seven quality statements from the Standard most relevant to scope. Feasibility was evaluated (9-point numeric rating scale; 1 = not at all feasible, 9 = highly feasible) for each quality statement across five dimensions. These dimensions, representing capability and opportunity, included OA knowledge, workflow, workload, remuneration, and infrastructure. Regression analyses examined associations between feasibility dimensions and pharmacy operational characteristics. Motivation and barriers were evaluated on Likert scales.
Results: A total of 407 pharmacists (61% women; mean [SD] age:39.5 [11.6] years), sampled from all Australian jurisdictions, participated. Median feasibility ratings across quality statements were highest for infrastructure (8) and lowest for remuneration (1–5). Time-intensive quality statements (self-management support, patient reviews) were rated as less feasible compared with diagnosis and medicines review. Higher staffing levels improved feasibility, while higher prescription volumes reduced it (p < 0.001; adjusted-R2 = 2–12%). Over 80% of participants agreed or strongly agreed they were motivated to deliver OA care. Key barriers that were applicable or highly applicable to delivery of Standard-aligned OA care included inadequate remuneration structures (83%), inadequate interprofessional care pathways (52.5%) and lack of awareness of OA care guidelines (41%).
Conclusion: Pharmacists reported strong motivation and perceived capability to deliver Standard-aligned OA care and considered it feasible with current infrastructure. However, systems barriers, particularly inadequate current remuneration and high workloads, limit opportunities. Addressing these barriers and optimizing workflows are essential to enable pharmacists to deliver consistent, high-quality OA care.