State Hospital Pharmacists’ Knowledge, Attitudes, and Practices on Medication Counselling: A Multicenter Cross-sectional Study in Sri Lanka

State Hospital Pharmacists’ Knowledge, Attitudes, and Practices on Medication Counselling: A Multicenter Cross-sectional Study in Sri Lanka | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article State Hospital Pharmacists’ Knowledge, Attitudes, and Practices on Medication Counselling: A Multicenter Cross-sectional Study in Sri Lanka Rathnaweera Bopage Janani Buddhika, Rana Weerasinghe Mudiyanselage Jayanthi Priyadarshani Jayasekera, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5415780/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 4 You are reading this latest preprint version Abstract Background Medication counselling is an essential element of health care, particularly in pharmacy practice, as it promotes adherence to medications and minimizes adverse effects. Hospital pharmacists play a crucial role in pharmaceutical care by ensuring that patients use medications safely and effectively. In Sri Lanka, the role of hospital pharmacists is largely restricted to dispensing medications, providing limited drug information, managing pharmaceutical inventories, and compounding extemporaneous preparations within hospital settings. This study aimed to evaluate the knowledge, attitudes, and practices of pharmacists regarding medication counselling in government hospitals in the Central Province of Sri Lanka. Methods A cross-sectional study was conducted in October 2022 across six state hospitals in the Central Province of Sri Lanka. A validated self-administered questionnaire was given to 160 hospital pharmacists to gather demographic details and assess their knowledge, attitudes, and practices related to medication counselling. The collected data were analysed via IBM SPSS software (version 25), and descriptive statistical methods were applied. Results Of the 160 pharmacists, 119 responded to the questionnaire. A majority (99.2%) affirmed that medication counselling is a core responsibility, with 97.5% reporting their active involvement in this task. Notably, 92% were engaged in counselling activities, and 68.9% had more than a decade of experience. While most respondents acknowledged the importance of providing complete medication information, more than 80% routinely discussed essential details such as medication names, indications, administration routes, dosages, frequencies, treatment durations, and storage guidelines. The identified barriers to effective counselling included time constraints (87%), limited knowledge (67%), lack of updated drug information (67%), and heavy patient loads (82%). Online training was preferred for professional development. Conclusion State hospital pharmacists actively participated in medication counselling and exhibited positive attitudes towards it. Many were open to seeking further knowledge to improve service quality. However, significant obstacles remain, such as time limitations, a lack of updated knowledge, and high patient demand. To address these issues, it is recommended that policymakers, hospital administrators, and pharmacists collaborate on strategies to strengthen medication counselling services, including the establishment of standard guidelines and patient education initiatives. knowledge attitudes practices medication counselling pharmacists hospitals Sri Lanka Background Pharmacists are generally more accessible than other healthcare professionals are and are often the final point of contact with patients before they begin taking their medications [ 1 ]. Pharmacists play a key role in ensuring positive outcomes in pharmaceutical care by educating and counselling patients, helping them adhere to their treatment plans, and monitoring schedules. Medication counselling is an important component of pharmaceutical care [ 2 ]. Medication counselling involves giving medication information either verbally or in writing to the patient or their caregivers, along with clear instructions on how to use the medication, information about potential side effects, proper storage, and recommendations on diet and lifestyle changes. This is typically accomplished through a direct, one-on-one interaction between the pharmacist and the patient or caregiver [ 3 , 4 ]. Medication counselling opportunities are key times for pharmacists to communicate with patients about their medications and the changes made to their treatments [ 5 ]. According to the revised International Pharmaceutical Federation (FIP) Basel Statements on the future of hospital pharmacies, “the overarching goal of hospital pharmacists is to optimize patient outcomes through collaborative, interprofessional, responsible use of medicines and medical devices”. Hospital pharmacists should serve as a resource for all aspects of medicine use and be accessible as a point of contact for patients and health care providers [ 6 ]. Medication counselling plays a crucial role in pharmacy practice [ 7 ]. Pharmacists are responsible for the treatment outcomes of their patients, and they can directly impact management outcomes by providing medication counselling to assist patients in the medication use process. Before dispensing medications, pharmacists should verify the accuracy of the drug supply at the counter. Pharmacists’ counselling has improved health-related outcomes in many acute and chronic diseases [ 8 ]. Patients who received pharmacist medication counselling before taking medication exhibited significantly better medication adherence than those who did not [ 9 ]. Pharmacist-mediated counselling promotes better knowledge, attitudes, and behaviours among patients, leading to more successful disease management. The "Good Pharmacy Practice" (GPP) guidelines of the National Medicine Regulatory Authority of Sri Lanka in 2019 specifically address the development of professional counselling strategies [ 9 ]. As the last contact professional before the patient consumes medication, pharmacists have a role in checking for drug allergies, recalling the messages regarding the appropriate use of medicines, ensuring adequate monitoring, providing guidance on adverse drug effects as well as drug interactions, and improving patients' medication adherence [ 10 ]. In Sri Lanka, the government is the primary healthcare supplier. It pays 50% of outpatient care and 95% of inpatient care, and almost all medical services are free at state hospitals. Pharmacists are essential members of healthcare teams who ensure that patients receive high-quality medical care. The purpose of this study was to assess state hospital pharmacists’ knowledge, attitudes, and practices regarding medication counselling at public hospitals in Central Province, Sri Lanka. In Sri Lanka, integrating medication counselling into routine pharmaceutical services in state hospitals is still in its early stages, and there are limited data on how pharmacists perceive this role, how much knowledge they possess about effective medication counselling, and how frequently they engage in this practice. This multicentre cross-sectional study aimed to address this gap by assessing the knowledge, attitudes, and practices of state hospital pharmacists in Sri Lanka regarding medication counselling. By surveying pharmacists from multiple hospitals across different regions, this study provides a comprehensive overview of the factors that influence pharmacists’ engagement in medication counselling, including their educational background, institutional support, and perceived barriers. Additionally, the study explores pharmacists’ attitudes toward medication counselling, such as their perceived responsibility in ensuring medication safety and patient understanding. The findings from this research not only contribute to the literature on pharmacy practices in Sri Lanka but also offer valuable insights for healthcare policymakers, hospital administrators, and professional bodies. By identifying gaps in knowledge, attitudes, and practices, this study could inform future training programmes, continuing education initiatives, and policy reforms aimed at strengthening the role of pharmacists in patient care. Ultimately, improving pharmacists’ engagement in medication counselling can lead to better patient outcomes, more efficient use of healthcare resources, and a stronger, more patient-centred healthcare system in Sri Lanka. Methods Study design and setting This study assessed hospital pharmacists’ knowledge, attitudes, and practices regarding medication counselling at public hospitals in Central Province, Sri Lanka. A descriptive, cross-sectional, multicenter study was conducted in October 2022 in six state hospitals in the Central Province of Sri Lanka. All the hospital pharmacists working at state hospitals in the Central Province of Sri Lanka were considered to constitute the population. The Central Province has 3 districts, Kandy, Nuwara Eliya, and Matale, as the order of the highest population. The six state hospitals were selected for study through convenience sampling. Study Hospital 1 (SH1) is a national hospital and the largest hospital in the Central Province. Study Hospital 2 (SH2) is a teaching hospital, Study Hospital 3 (SH3) is the second largest children’s hospital in Sri Lanka, and Study Hospital 4 (SH4) is a base hospital. SH1 to SH4 were selected from the Kandy district. Study Hospital 5 (SH5) is a district hospital in Nuwara Eliya, and Study Hospital 6 (SH6) is a district hospital in the Matale district. The details of the selected hospitals and the number of pharmacists working at the selected state hospitals are shown in Table 1 . Table 1 Details of the selected study hospitals Selected hospitals for the study District Type of hospital No. of beds No. of pharmacists Study Hospital 1 (SH1) Kandy National Hospital 2492 78 Study Hospital 2 (SH2) Kandy Teaching Hospital 957 26 Study Hospital 3 (SH3) Kandy Children’s Hospital 342 16 Study Hospital 4 (SH4) Kandy Base Hospital 357 15 Study Hospital 5 (SH5) Nuwara Eliya District General Hospital 1026 10 Study Hospital 6 (SH6) Matale District General Hospital 825 15 Study participants The study cohort included hospital pharmacists working at 6 selected state hospitals. One hundred and sixty pharmacists were working at 6 selected hospitals (SH1, 78; SH2, 26; SH3, 16; SH4, 15; SH5, 10; SH6, 15). Inclusion and exclusion criteria Pharmacists who were working at selected state hospitals in Central Province, Sri Lanka, with more than three months of previous service experience as hospital pharmacists were included in the study. Pharmacy students, interns, and hospital pharmacists who were absent from their duties and those who declined to participate were excluded from the study. Sampling method and technique All the pharmacists working at the selected 6 hospitals were included in the study. Data collection A validated, self-administered questionnaire was used in this study to collect data on pharmacists’ knowledge, attitudes, and practices related to medication counselling. The questionnaire was developed after reviewing previous similar surveys with some modifications. The questionnaire was subjected to a review and a validation process. The readability and understanding of the developed questionnaire were then verified among 16 randomly selected hospital pharmacists (10% of 160) working at different state hospitals with settings similar to those of the selected hospitals. Face validation of the questionnaire was carried out by colleagues from the inpatient department of SH1, and content validation was finalized by discussing the questionnaire with content experts of graduate hospital pharmacists, pharmacy academics, and a statistician. The internal consistency of the Likert scale questions of the questionnaire was measured by calculating Cronbach’s alpha value, which was found to be 0.71 for 8 questions on the Likert scale for measuring attitudes and 0.78 for 4 questions on the Likert scale for measuring practices, which means that there is acceptable reliability and consistency between the set of test items. The questionnaire consisted of four parts. The first part collected the demographic information of the participants, including five questions (age, sex, experience, educational background, and sections they had worked/or working). Participants were allowed to select multiple responses to the question on sections they had worked/or working at the hospital. The second part collected information on knowledge, including eight questions such as awareness of medication counselling, areas that should be covered in counselling, different information sources, and special patient conditions. The third section consisted of 10 questions on the attitudes of hospital pharmacists; 3 questions on professional development programmes, barriers to medication counselling, and appropriate strategies to overcome barriers were used, with two response options: “Yes” and “No”; and 7 questions with a 5-level Likert rating scale. The attitude dimension ranged from 1 “strongly agree” to 5 “strongly disagree”. The fourth part assessed current practices of counselling with two response options: “Yes” and “No”, multiple answer questions, single answer questions, and 4 questions with a 5-level Likert rating scale. Ethical approval was obtained from the Ethics Review Committee at the Open University of Sri Lanka (FH/ERC/10). The questionnaire was developed in the English language and hand-delivered to the participants. Process of data collection Data were collected in October 2022. After the approval of the relevant heads of the government hospitals was obtained, the chief pharmacists were informed about the study. The objectives of the study were explained. Written informed consent from the pharmacists was obtained, and they were assured that their participation in this study was voluntary and that their confidentiality would be maintained. The final data collection tool was distributed to pharmacists working at selected government hospitals in Central Province. Fifteen to thirty minutes were given to the respondents to complete and return the questionnaire to the investigator. Results Demographic information Out of 160 hospital pharmacists, only 137 responded, and 119 questionnaires were analysed after 28 incomplete questionnaires were removed. The demographic characteristics are shown in Table 2 . There were more females (58.5%) than male participants. The highest professional qualification of the majority of the respondents was diploma in pharmacy (80.7%), which was offered by the Ministry of Health. A majority (68.9%) of the hospital pharmacists had over 10 years of experience. The participants were allowed to select multiple responses for the question on the working or working section. Among the 119 respondents, 83.2% reported the “Out Patients Department”, 54.6% responded to the “In Patients Department”, and 36.1% responded to the “Drug/Surgical Stores”. Twenty-four participants (20.2%) reported working or working in the “Counselling section”. Other categories reported by 21.8% of the respondents included “local purchase unit”, “cancer unit”, administration office, etc. [ 11 ] Table 2 Demographic characteristics of hospital pharmacists (N = 119) Characteristics Category Frequency Percentage (%) Age (In years) * (N = 118) 20–29 4 3.4% 30–39 48 40.7% 40–49 36 30.5% >=50 30 25.4% Missing 1 Sex * (N = 118) Female 69 58.5% Male 49 41.5% Missing 1 Highest educational qualification * (N = 119) Diploma in Pharmacy by Ministry of Health 96 80.7% Degree in Pharmacy 11 9.2% Other Degree 11 9.2% Postgraduate 1 0.8% Duration of service in the hospital * (N = 119) 3 months to 1 year 2 1.7% 1 to 5 years 12 10.1% 5 to 10 years 23 19.3% More than 10 years 82 68.9% Sections worked/or working ** (N = 119) Out Patients Department 99 83.2% In Patients Department 65 54.6% Drug/Surgical Stores 43 36.1% Counselling section 24 20.2% Other 26 21.8% * Percentages were calculated on the basis of the number of participants who responded to each demographic variable. Missing data are indicated where applicable. **Multiple responses were allowed for the question—sections worked/or working. The sum of percentages may exceed 100% , as participants were allowed to select more than one option. Knowledge of hospital pharmacists on medication counselling Most of the pharmacists (99.2%) had heard that medication counselling is one of their responsibilities. Most pharmacists (97.5%) knew that the pharmacists themselves should be involved in medication counselling. A significant proportion of the pharmacists responded that physicians (73.1%) and nurses (66.4%) should also be involved in medication counselling. Regarding the sources of information used for updating knowledge, internet sources (94.1%) were the most popular choice. Formularies and guidelines (90.8%) and leaflets (83.2%) were also the primary sources used for updating the knowledge (Table 03 ). Table 03 Sources of information used by state hospital pharmacists to update their knowledge (N = 119) Sources of information Frequency Percentage (%) Formularies and guidelines 108 90.8% Friends 52 43.7% Internet 112 94.1% Other members of the healthcare team 92 77.3% Drug information bulletins 88 73.9% Books 82 68.9% Leaflets 99 83.2% The majority (86.4%) of the hospital pharmacists responded that they should update their knowledge “always”. Pharmacists were well aware of the type of information that should be provided during medication counselling (Table 04 ). More than 90% of the participants responded that medication-related information such as names of medications, duration of treatment, precautions, special directions, common side effects, contraindications, and proper storage conditions should be provided during medication couselling. Other aspects, such as lifestyle changes and appropriate actions to be taken in the case of missed doses, were recognized by pharmacists to a lesser extent. Table 4 State hospital pharmacists’ knowledge of medication counselling Pharmacists’ knowledge on medication counselling Frequency Percentage (%) What information should be given to the patients during patient counselling?** Diagnosis of disease 40 33.6% Names of the medications 111 93.3% Duration of the treatment 110 92.4% Precautions 108 90.8% Special directions 114 95.8% Common side effects 114 95.8% Lifestyle changes 100 84.0% Contra-indications 112 94.1% Therapeutic indication 73 61.3% Proper storage 113 95.0% Refill information 74 62.2% Appropriate actions to be taken in case of missed dose 101 84.9% 2. What frequency pharmacists should update their knowledge on medication counselling? Always 102 86.4% Often 14 11.9% Sometimes 2 1.7% **Multiple responses were allowed for the question—sections worked/or working. The sum of percentages may exceed 100%, as participants were allowed to select more than one option. Attitudes of hospital pharmacists toward medication counselling A significant majority (82.4%) of the pharmacists strongly agreed, and an additional 16.8% agreed, that counselling is part of their responsibilities. The responses to the statement "I would be embarrassed if I do not know how to answer questions from patients" were more varied; the majority were neutral (33.3%), whereas only 14.9% strongly agreed. A substantial proportion (57%) agreed that they should have allocated time for medication counselling, although this was split between strongly agreeing (39.5%) and agreeing (57.1%). A high proportion of the pharmacists reported enjoying medication counselling (43.7% strongly agree, 44.5% agree), and most believed that patients/guardians valued their counselling (23.1% strongly agree, 54.7% agree). Among the respondents, 78.2% strongly agreed that proper medication counselling can reduce medication misuse (Table 5 ). Table 5 State hospital pharmacists’ attitudes towards medication counselling Statement SA A N D SD Mode Medication counselling is a part of a pharmacist’s duty 98 20 - - 1 SA (82.4%) Medication counselling is a joint responsibility of both pharmacist and physician 60 57 - 2 - SA (50.4%) I should provide information regarding medications issued to patients regardless of waiting for the request of the patient for the information 37 54 15 6 1 A (47.8%) I should have allocated time for medication counselling 47 68 4 - - A (57.1%) I would be embarrassed if I do not know how to answer questions from patients regarding their medications 17 26 38 25 8 N (33.3%) I enjoy medication counselling 52 53 12 2 - SA (43.7%) Patients/guardians would like to get counselling from me 27 64 23 3 - A (54.7%) Proper medication counselling will reduce the misuse of medications by patients 93 24 - - 2 SA (78.2%) *SA = Strongly Agree, A = Agree, N = Neutral, D = Disagree, SD = Strongly Disagree **Mode: The response option selected by the majority for each statement. Online training was the preferred method for improving knowledge through continuous professional development programmes and was chosen by 76.5% of the pharmacists. Monthly seminars were the next preferred method, selected by 41.2% of the pharmacists. Weekend workshops and evening tutorials were less favoured, with 19.3% and 4.2% of the pharmacists choosing them, respectively, possibly owing to practical constraints on their availability. The primary barrier to effective medication counselling, which was responded to by 76.5% of the pharmacists, was the lack of time. Other commonly reported barriers included a shortage of pharmacists skilled in medication counselling (44.5%), limited patient awareness of pharmacists’ counselling expertise (37.0%), low patient demand for counselling (34.5%), and lack of interest in counselling among some pharmacists (25.2%). To address these challenges, enhancing pharmacist knowledge of medication counselling and raising public awareness about pharmacists’ counselling capabilities were identified as the top strategies by 63.9% and 53.8% of respondents, respectively. Additionally, other potential solutions included creating private consultation spaces within pharmacies (49.6%) and increasing pharmacy staffing (39.5%) to support more effective counselling services (Table 06 ). Table 6 State hospital pharmacists’ attitudes towards continuous professional development courses and barriers to medication counselling. Pharmacists’ attitudes of medication counselling Frequency Percentage (%) 1. What are your preferred methods to improve knowledge from continuous professional development programmes?** Monthly seminars 49 41.2% Regular classroom-type teaching 8 6.7% Weekend workshops 23 19.3% Evening tutorials 5 4.2% Online training 91 76.5% 2. In your opinion, which of the following are barriers to medication counselling?** Lack of patient awareness about pharmacist’s expertise in medication counselling 44 37.0% Lack of pharmacist time for counselling 91 76.5% Lack of pharmacists who are expertise in medication counselling 53 44.5% Lack of patient demand for counselling 41 34.5% Lack of pharmacist interest in counselling 30 25.2% 3. In your opinion, what are the appropriate strategies to overcome barriers for medication counselling?** Increase public awareness about pharmacist’s ability for medication counselling 64 53.8% Improve pharmacist’s knowledge about medication counselling 76 63.9% Establish private consultation area in the pharmacy 59 49.6% Improve pharmacist’s communication skills 60 50.4% Increase staffing in pharmacy 47 39.5% **Multiple responses were allowed for the question. The sum of percentages may exceed 100%, as participants were allowed to select more than one option. Practices of hospital pharmacists on medication counselling The majority of the pharmacists (92%) responded that they are engaged in medication counselling, whereas the rest of the pharmacists responded that they are working at surgical stores and other sections where direct patient contact was minimal. The study reported that a considerable number of pharmacists engaged in medication counselling (always 33%, frequently 35%). Among the 119 hospital pharmacists surveyed, 46.2% reported having printed materials to supply patients during counselling, whereas 45.4% indicated that they did not have such materials. The remaining ten respondents (8.4%) did not provide answers to this question. Among the 119 hospital pharmacists surveyed, 51.3% reported following established guidelines when counselling patients, whereas 42.9% indicated that they did not follow any specific guidelines. Seven respondents (5.9%) did not provide an answer to this question". More than 80% of the participants reported that they provided information on the medication name, indication, route of administration, prescribed dose, frequency of administration, duration of treatment, and storage conditions. The majority (87.4%) of the participants reported that providing insufficient time for counselling was a challenge. Only 29.4% of the pharmacists claimed that hospitals offered training programmes to educate pharmacists about counselling. The study also revealed that pharmacists had different ways of improving their knowledge of medication counselling, with the majority (79.0%) preferring to use the internet, followed by continuing professional development (CPD) programmes outside of hospitals (45.4%), learning from senior pharmacy colleagues (39.5%), textbooks (47.9%), and other hospital staff (19.3%) (Table 7 ). Table 7 Practices of hospital pharmacists during medication counselling 1. What information is provided by pharmacists during medication counselling?** Pharmacist’s practices during medication counselling Frequency Percentage (%) Name of drug 106 89.1% Route of administration 102 85.7% Dose of drug 106 89.1% Frequency of administration 106 89.1% Indication 96 80.7% Duration of therapy 100 84.0% Drug interactions 87 73.1% Storage conditions 104 87.4% Give written materials 77 64.7% 2. What are the difficulties you face when medication counselling?** Insufficient time 104 87.4% Insufficient knowledge 30 25.2% I feel embarrassed 9 7.6% Other 11 9.2% 3. How you improve your knowledge related to medication counselling?** From continuous professional development courses outside of the hospital 54 45.4% From the training programs conducted at the hospital 35 29.4% From my senior pharmacy colleagues 47 39.5% From other hospital staff (physicians, nurses) 23 19.3% From internet 94 79.0% From textbooks 57 47.9% 4. Do you have any printed materials to be supplied to patients when counselling? Yes 55 50.5% No 54 49.5% 5. Do you follow any written guidelines when counselling? Yes 61 54.5% No 51 45.5% 6. What are the difficulties you face when counselling?** Insufficient time 104 87.4% Insufficient knowledge 30 25.2% I feel embarrassed 9 7.6% Other 11 9.2% 7. How do you improve your knowledge related to counselling?** From continuous professional development courses outside of the hospital 54 45.4% From the training programs conducted at the hospital 35 29.4% From my senior pharmacy colleagues 47 39.5% From other hospital staff (physicians, nurses) 23 19.3% From internet 94 79.0% From textbooks 57 47.9% **Multiple responses were allowed for the question. The sum of percentages may exceed 100%, as participants were allowed to select more than one option. The majority of the pharmacists agreed (25.8% strongly agree, 56.9% agree) that a high workload prevents them from engaging in medication counselling. More than half of the participants agreed that physicians appreciate their role in medication counselling, whereas 40.2% of the participants’ responses were “neutral”. Eighty percent of the participants (25.6% strongly agree, 60.2%) agreed) accepted themselves as actively involved in medication counselling as part of the healthcare team. A major proportion of the pharmacists (22.9% strongly agree, 66.1% agree) reported that they engaged in medication counselling while dispensing medications, and no respondents disagreed (Table 8 ). Table 8 Hospital pharmacists’ engagement in medication counselling Statement SA A N D SD Mode A high workload prevents me from doing medication counselling 30 66 15 4 1 A (56.9%) Physicians appreciate that I am engaged in medication counselling 15 51 45 1 - A (45.5%) I am engaged in medication counselling as a part of the healthcare team 29 68 14 1 1 A (60.2%) I do medication counselling while dispensing medication 27 78 11 - - A (67.2%) *SA = Strongly Agree, A = Agree, N = Neutral, D = Disagree, SD = Strongly Disagree **Mode: The response option selected by the majority for each statement. Discussion The terms "medication counselling" and "patient medication counselling" often refer to interactions between pharmacists and patients focused on providing and discussing essential information about medications [ 11 ]. Pharmacist counselling is an intervention directed at patients’ health-related needs, which also improves interprofessional and interinstitutional communication [ 8 ]. Offering counselling directly at the point of medication delivery in the pharmacy allows pharmacists to enhance medication safety and greatly improve patient adherence. The pharmacist is the primary source of general advice on medicines and health, and counselling aims to direct patients to use medications more safely and effectively [ 12 ]. Notably, to our knowledge, this is the first study in Sri Lanka assessing the knowledge, attitudes, and practices of pharmacists regarding medication counselling. In this study, the majority of the pharmacists’ highest education qualification was the Diploma in Pharmacy offered by the Ministry of Health, Sri Lanka, which has a two-year diploma. In most countries, the basic requirement to practice as a hospital pharmacist is to have a degree in pharmacy [ 13 – 15 ]. A majority of the hospital pharmacists in this study had over 10 years of experience, and similar findings were reported in a study conducted in Ohio [ 16 ]. In another study conducted in Ethiopia on medication counselling by pharmacists, the majority of the pharmacists had 5 to 10 years of experience, while the proportion of those with more than 10 years of experience was minimal [ 17 ]. A similar study conducted in Malaysia reported that only 9.7% of hospital pharmacists had more than 10 years of experience [ 18 ]. The majority of the hospital pharmacists had either worked or were working at the “Out Patients Department”, where they dispensed medicines to the patients directly and engaged in medication counselling. Knowledge of hospital pharmacists on medication counselling Almost all the pharmacists in this study responded that medication counselling is one of their responsibilities and that the pharmacists themselves should be involved in medication counselling, indicating a high level of self-awareness and responsibility for the role of counselling. Similar findings have been reported from a study conducted on the attitudes and behaviours of community pharmacists on medication counselling in India, “as medication counselling is a professional obligation” [ 19 ]. Additionally, the pharmacists responded that other healthcare team members, such as physicians and nurses, should also be involved in medication counselling, highlighting the importance of a multidisciplinary approach to patient care. Hospital pharmacists are strongly committed to continuous professional development, with the majority indicating that they believe that they should "always" update their knowledge. The most widely used resource for updating information on medication counselling was reported as an internet source, reflecting the growing importance of online resources in the healthcare field. Formularies, guidelines, and leaflets were reported as the second and third most commonly used sources for updating knowledge in this study. A study conducted in Nigerian reported reference books such as the British National Formulary, the internet, and drug information leaflets as the most commonly used sources for knowledge updates for medication counselling [ 15 ]. Moreover, the pharmacists demonstrated a clear understanding of the type of information that should be provided during medication counselling, ensuring that patients receive relevant details to support medication adherence and understanding. A vast majority of the pharmacists responded that they provide names of medications, durations of treatment, precautions, special directions, common side effects, contraindications, and proper storage conditions during medication counselling. A study conducted in Ethiopia reported that information on the frequency of administration, route of administration, dose of drugs, and duration of therapy was the most common form of drug information given during medication counselling by pharmacists [ 17 ]. Some countries have medication counselling guidelines developed for pharmacists to ensure that all patients receive the most important information [ 20 ]. Attitudes of hospital pharmacists toward medication counselling This study reported a strong commitment among pharmacists to medication counselling as an integral aspect of their duties. This aligns with global research indicating that pharmacists widely recognize medication counselling as an essential component of their professional role. Studies in both developed and developing countries have reported similar findings, where pharmacists view patient education and counselling as critical to ensuring medication safety and adherence [ 21 , 22 ]. Pharmacists’ responses were more varied regarding statements about being embarrassed if unable to answer patients’ questions, with only 14.9% strongly agreeing and a majority remaining neutral (33.3%). This reflects potential uncertainty or variability in pharmacists’ confidence levels when handling complex or unexpected queries. A lack of pharmacists’ confidence in counselling was reported by only 6.4% of hospital pharmacists in Ohio, USA [ 16 ]. The findings suggest that the development and introduction of training programmes in communication skills and continuous professional education may help pharmacists feel more confident in patient interactions. The desire for dedicated time for medication counselling is a critical finding, with a substantial proportion supporting the idea, either strongly agreeing or agreeing. Time constraints have been frequently cited as a barrier to effective counselling in various settings, as pharmacists are often burdened by competing responsibilities that limit their capacity for in-depth interactions with patients [ 23 ]. Providing pharmacists with allocated time and a dedicated area for counselling could significantly enhance the quality and depth of patient education, supporting the trend towards more patient-centred pharmacy practice seen in other research. A high proportion of pharmacists enjoy medication counselling and believe that patients value this service. This is supported by the findings of a study conducted in Belgium where pharmacists reported that patients needed to tell their stories and discuss how they would manage medicines when returning home [ 24 ]. The satisfaction derived from medication counselling suggests that many pharmacists find personal and professional fulfilment in these interactions. Additionally, the belief that patients value their counselling services reflects positively on the pharmacist-patient relationship, fostering trust and reinforcing the role of pharmacists as essential healthcare providers. A high level of patient satisfaction with medication counselling is reported in terms of the amount of information received as verbal and written information about their medication [ 25 ]. The majority of respondents in this study strongly agreed that effective medication counselling could reduce medication misuse. This finding resonates with other research highlighting the positive impact of pharmacist-patient interactions on reducing medication errors and misuse. According to previous studies, comprehensive counselling on medication use, potential side effects, and adherence strategies significantly reduce the risk of adverse drug events and noncompliance [ 26 ]. Pharmacists’ understanding of the value of counselling is crucial for their engagement with patients, as effective counselling has been shown to improve both clinical outcomes and patient safety [ 27 , 17 , 28 , 29 ]. Pharmacists worldwide use continuing education (CE) or continuing professional development (CPD) to stay current with knowledge and skills throughout their careers [ 27 ]. In this study, more than 75% of participants preferred online CPD programmes, whereas in a study conducted among Lebanese hospitals, pharmacists (60.6%) also preferred computer-based CPD programmes [ 28 ]. Monthly seminars were also preferred, suggesting a willingness to engage in face-to-face learning opportunities. A lack of time for medication counselling was identified as the most significant barrier to medication counselling, chosen by a majority (76.5%) of the pharmacists. This suggests that time constraints in a busy pharmacy environment can hinder the provision of comprehensive patient counselling services. A focus group study conducted among hospital pharmacists in Australia also reported that time pressure caused by the hospital was a major challenge for medication counselling at hospitals [ 29 ]. This finding is supported by a cross-sectional survey conducted in Saudi Arabia among community pharmacists, which reported that a common barrier for pharmacists in providing counselling to patients was a lack of time due to their other responsibilities [ 30 ]. Workload and time limitations are frequently reported as obstacles to effective medication dispensing and patient counselling in various areas [ 16 , 31 , 32 ]. Pharmacists have various resources available to improve communication with patients, particularly those who face health literacy challenges [ 11 ]. Enhancing the knowledge and communication abilities of pharmacists was seen as vital for overcoming counselling barriers. Increased public awareness of the pharmacist's ability for medication counselling was identified as an important strategy by 54% of the pharmacists. These findings indicate that patient engagement and understanding of the pharmacist's role in counselling can positively impact counselling opportunities. Practices of hospital pharmacists on medication counselling Proper dispensing practices ensure that the correct medication, in an effective form and appropriate dosage, is provided to the right patient in the right quantity, with clear instructions and packaging that preserves the drug’s potency [ 33 ]. In Brazil, as per the regulations, dispensing includes “the pharmacist’s role in providing instructions, medications, and medicinal products to a patient, as a remunerated work or not” [ 34 ]. In most regions, only pharmacists have the authority and responsibility to dispense medications, although some also allow doctors and/or nurses to perform this role. Medication counselling is an essential part of the dispensing process, providing patients with the necessary information to understand their medications and their intended therapeutic effects. Patients should always be encouraged to ask questions and seek clarification on any details [ 33 ]. The fact that 85% of the pharmacists reported counselling during dispensing highlights the strength of existing practices. This suggests that patient interactions during dispensing were viewed as an opportune moment for counselling, although some (9%) may find it challenging to engage fully during this time. In some countries, counselling via telephone has resulted in improved patient adherence [ 35 ]. While more than half of the pharmacists felt appreciated by physicians, a substantial number remained neutral. Similarly, 8.9% of the physicians were not sure about the need for counselling by a pharmacist [ 36 ]. The findings of this study indicate a lack of communication or formal acknowledgement of the pharmacist's role in medication counselling within the healthcare team. Physicians, pharmacists, and nurse trios have been identified as members of multidisciplinary drug review teams [ 37 ]. This study revealed that most pharmacists perceived themselves as integral to medication counselling within the healthcare team, indicating that their role in this area is well established. The small percentage of disagreement suggests that a minority may feel excluded or lack formal integration into the team’s counselling efforts. Lowering the dispensing workload may allow pharmacists time to review prescriptions and help reduce dispensing errors [ 38 ]. The overwhelming agreement (80%) that workload prevented medication counselling indicated a critical area for improvement. Similar findings were reported in other studies in which workload negatively affected medication counselling [ 5 , 16 , 29 ]. This could imply a need for workflow improvements or additional staffing to allow pharmacists more time for patient interactions [ 16 ]. Among the 119 hospital pharmacists surveyed, 46.2% reported providing printed materials to patients during medication counselling. A study conducted in a rural district in Sri Lanka among chronic kidney disease (CKD) patients reported that counselling sessions led by a trained clinic-based pharmacist providing written drug and disease information, along with verbal education in local languages, helped enhance drug and disease knowledge for patients with CKD [ 39 ]. In addition to printed material, including written information, pictograms are also used in medication counselling. Some studies have shown no significant effect of pictogram-based counselling when caregivers already possess adequate literacy levels [ 40 ]. However, other studies suggest that both types of caregivers with low literacy levels and those with high literacy levels may benefit from pictogram-assisted counselling approaches [ 41 , 42 ]. The findings of this study indicate that there is almost an even split between pharmacists who have printed materials available for medication counselling and those who do not. Furthermore, while a slight majority of hospital pharmacists follow established guidelines when counselling patients, a significant proportion (42.9%) do not adhere to any formal guidelines. This variation in practice may affect the consistency and quality of patient counselling provided by pharmacists. These gaps highlight the potential need for healthcare institutions to provide standardized educational materials, which can enhance the quality and consistency of medication counselling provided by pharmacists. Limitations of the study This study investigated only the knowledge, attitudes, and practices related to medication counselling at six government hospitals in Central Province. Assessing these parameters at other hospitals in the central province would be more representative. Furthermore, assessing the awareness of other healthcare members on medication counselling by pharmacists would be highly valuable. Moreover, the study did not examine patients’ perceptions of medication counselling by hospital pharmacists. Conclusions Hospital pharmacists in the Central Province of Sri Lanka have a strong understanding of medication counselling and its importance. Further studies are suggested to identify suitable approaches to enhance medication counselling conducted at state hospitals. A notable majority of the participants had over ten years of experience and held a diploma in a pharmacy, with many working primarily in outpatient departments. Pharmacists showed a strong awareness of their responsibilities in medication counselling and favoured continuous knowledge updates, predominantly via internet sources. The results indicate a positive attitude towards medication counselling, with most pharmacists recognizing its value in reducing medication misuse. However, barriers such as high workload and limited time are commonly reported, restricting the ability to engage in medication counselling effectively. Strategies such as implementing private consultation areas, increased staffing, and structured training programmes are recommended to address these obstacles. Providing training and guidelines for medication counselling and initiating policy decisions to facilitate medication counselling by pharmacists are recommended. Furthermore, the pharmacist’s knowledge, communication skills, and public awareness of the pharmacist's role should be improved. Abbreviations SH: Study Hospital 1; CE: Continuing Education; CPD: Continuing Professional Development; CKD: Chronic Kidney Disease Declarations Ethics approval and consent to participate The Ethics Review Committee of the Open University of Sri Lanka approved the study (FH/ERC/10). Administrative approval was obtained from the directors of the relevant state hospitals. All methods were performed following relevant guidelines and regulations. The data were kept confidential and were only used for the intended purpose. Consent for publication: The consent to publish the information gathered from the state hospitals was obtained from the heads of the relevant hospitals. The data are reported such that it will not be possible to identify the individual institutions. Availability of data and materials The questionnaire and datasets analysed during the current study are available from the corresponding author upon reasonable request. Competing interests: The authors declare that they have no competing interests. Funding The study was self-funded. Authors’ contributions RBJB and JRWMJP conceived the idea of the study, and all the authors participated in designing the study. JRWMJP was involved in the data collection. RBJB, JRWMJP and NDDW were involved in the analysis and interpretation of the data. RBJB, JRWMJP, and NDDW drafted the manuscript, and RBJB, JRWMJP, and NDDW critically revised it. All the authors read and approved the final manuscript. Acknowledgements We would like to express our gratitude to the hospital pharmacists working at state hospitals in the central province for their cooperation during data collection. Authors' information 1 Department of Pharmacy, Faculty of Health Sciences, The Open University of Sri Lanka, Nugegoda, Sri Lanka, 2 District General Hospital, Kandy, Sri Lanka Informed consent: Informed written consent was obtained from the hospital pharmacists in this study. References Tsuyuki, R.T., Beahm, N.P., Okada, H., Al Hamarneh, Y.N.: Pharmacists as accessible primary health care providers: Review of the evidence, (2018) Heplhr, C.D., Strand, L.M.: Opportunities and responsibilities in pharmaceutical care. 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Canadian Journal of Rural Medicine. 26, 151–159 (2021). https://doi.org/10.4103/cjrm.cjrm_74_20 Preece, D., Holme, K., Frontini, R., Tromp, D., Price, R.: Admission into primary care: Are we doing enough? European Journal of Hospital Pharmacy. 21, 79–83 (2014). https://doi.org/10.1136/ejhpharm-2013-000374 Desplenter, F.A., Laekeman, G.M., Simoens, S.R.: Constraints and perspectives of pharmacists counselling patients with depression at hospital discharge. Int J Clin Pharm. 33, 101–110 (2011). https://doi.org/10.1007/s11096-010-9465-y Mai, A., Aslani, P.: Impact of Vietnamese written and verbal medicine information on Vietnamese-speaking Australians’ knowledge and satisfaction. Br J Clin Pharmacol. 64, 527–535 (2007). https://doi.org/10.1111/j.1365-2125.2007.02968.x Said, A., Hussain, N., Abdelaty, L.N.: Physicians’ and pharmacists’ perception and practice of hospital pharmacist professional role in Egypt. International Journal of Pharmacy Practice. 28, 491–497 (2020). https://doi.org/10.1111/ijpp.12638 Micallef, R., Kayyali, R.: A Systematic Review of Models Used and Preferences for Continuing Education and Continuing Professional Development of Pharmacists. Pharmacy. 7, 154 (2019). https://doi.org/10.3390/pharmacy7040154 Iskandar, K., Raad, E.B., Hallit, S., Chamoun, N., Usta, U., Akiki, Y., Karaoui, L.R., Salameh, P., Zeenny, R.M.: Assessing the perceptions of pharmacists working in lebanese hospitals on the continuing education preferences. Pharm Pract (Granada). 16, (2018). https://doi.org/10.18549/PharmPract.2018.02.1159 Chevalier, B.A.M., Watson, B.M., Barras, M.A., Cottrell, W.N.: Hospital pharmacists’ perceptions of medication counselling: A focus group study. Research in Social and Administrative Pharmacy. 12, 756–771 (2016). https://doi.org/10.1016/j.sapharm.2015.10.007 Al-Arifi, M.N.: Availability and needs of herbal medicinal information resources at community pharmacy, Riyadh region, Saudi Arabia. Saudi Pharmaceutical Journal. 21, 351–360 (2013). https://doi.org/10.1016/j.jsps.2012.11.004 Kentab, B.Y., Barry, H.E., Al-Aqeel, S.A., Hughes, C.M.: Improving medication dispensing and counselling for patients with vision impairment: a qualitative study of pharmacist-reported barriers and facilitators. BMC Health Serv Res. 24, (2024). https://doi.org/10.1186/s12913-024-11009-9 Walker, S.A.N., Lo, J.K., Compani, S., Ko, E., Le, M.-H., Marchesano, R., Natanson, R., Pradhan, R., Rzyczniak, G., Teo, V., Vyas, A.: Identifying Barriers to Medication Discharge Counselling by Pharmacists. Can J Hosp Pharm. 67, 203–212 (2014). https://doi.org/10.4212/cjhp.v67i3.1357 Paulino, E., Thomas, D., Lee, S.W.H., Cooper, J.C.: Dispensing process, medication reconciliation, patient counselling, and medication adherence. In: Clinical Pharmacy Education, Practice and Research: Clinical Pharmacy, Drug Information, Pharmacovigilance, Pharmacoeconomics and Clinical Research. pp. 109–120. Elsevier (2019) Ferreira, T.X.A.M., Prudente, L.R., Dewulf, N. de L.S., Provin, M.P., Mastroianni, P. de C., da Silveira, E.A., Amaral, R.G.: Medication dispensing as an opportunity for patient counselling and approach to drug-related problems. Brazilian Journal of Pharmaceutical Sciences. 52, 151–162 (2016). https://doi.org/10.1590/S1984-82502016000100017 Kooy, M.J., Van Geffen, E.C.G., Heerdink, E.R., Van Dijk, L., Bouvy, M.L.: Effects of a TELephone Counselling Intervention by Pharmacist (TelCIP) on medication adherence, patient beliefs and satisfaction with information for patients starting treatment: Study protocol for a cluster randomized controlled trial. BMC Health Serv Res. 14, (2014). https://doi.org/10.1186/1472-6963-14-219 Adnan, S., Tanwir, S., Abbas, A., Beg, A.E., Sabah, A., Safdar, H., Moin, M., Fatima, R., Mobeen, K., Shams, M.: PERCEPTION OF PHYSICIANS REGARDING PATIENT COUNSELING BY PHARMACIST: A BLEND OF QUANTITATIVE AND QUALITATIVE INSIGHT. International Journal of Pharmacy & Therapeutics. 5, 117–121 (2014) Zaij, S., Pereira Maia, K., Leguelinel-Blache, G., Roux-Marson, C., Kinowski, J.M., Richard, H.: Intervention of pharmacist included in multidisciplinary team to reduce adverse drug event: a qualitative systematic review. BMC Health Serv Res. 23, (2023). https://doi.org/10.1186/s12913-023-09512-6 Shao, S.C., Chan, Y.Y., Lin, S.J., Li, C.Y., Yang, Y.H.K., Chen, Y.H., Chen, H.Y., Lai, E.C.C.: Workload of pharmacists and the performance of pharmacy services. PLoS One. 15, (2020). https://doi.org/10.1371/journal.pone.0231482 Wickramasinghe, D., Lynch, C., Coombes, J., Jayamanne, S., De Silva, S.: Improving Drug- and Disease-related Knowledge of Patients with Chronic Kidney Disease: Randomized Controlled Trial from a Sri Lankan Outpatient Clinic. Asian Journal of Pharmaceutical Research and Health Care. 16, 208–215 (2024). https://doi.org/10.4103/ajprhc.ajprhc_36_24 Yin, H.S., Mendelsohn, A.L., Fierman, A., Van Schaick, L., Bazan, I.S., Dreyer, B.P.: Use of a pictographic diagram to decrease parent dosing errors with infant acetaminophen: A health literacy perspective. Acad Pediatr. 11, 50–57 (2011). https://doi.org/10.1016/j.acap.2010.12.007 Hu, H., Wu, F.L.L., Hu, F.C., Yang, H.Y., Lin, S.W., Shen, L.J.: Effectiveness of education programs about oral antibiotic suspensions in pediatric outpatient services. Pediatr Neonatol. 54, 34–42 (2013). https://doi.org/10.1016/j.pedneo.2012.10.002 Tork, H.M.M.: A Pictogram-Based Intervention to Reduce Parental Liquid Medication Errors: Health Literacy Approach. American Journal of Nursing Science. 2, 27 (2013). https://doi.org/10.11648/j.ajns.20130203.12 Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5415780","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":378305962,"identity":"93e1e2cc-d813-4a4f-beab-a77100484bc0","order_by":0,"name":"Rathnaweera Bopage Janani Buddhika","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA90lEQVRIiWNgGAWjYBACxgYQaXCAgeFADsPBBgYbkFjjAVK0pIHF8GqBAogWoP7DMC5uwNx+9uDngoI7iX3Hcw8enFFz3m5t+2GgLTU20Tgd1pOXLD3D4FnizDPvEg5uOHY7eduZRKCWY2m5DTj9kmMgzWNwOHHDjRyDgw/YbiebHQBqYWw4jFtL/xvj3wgt/84lm51/SEDLjBwzhC0b2w7Ymd0gZMuMN2bWPAbPjGeeeWNwcGZfcoLZDaAtCXj8YtifY3yb588d2b7jOcYfe77Z2ZudT3/44EONDW4t6BKJYIEEHMpBQB5dwB6P4lEwCkbBKBihAAC9aHRTMzRYpQAAAABJRU5ErkJggg==","orcid":"","institution":"Department of Pharmacy, Faculty of Health Sciences, The Open University of Sri Lanka, Nugegoda, Sri Lanka","correspondingAuthor":true,"prefix":"","firstName":"Rathnaweera","middleName":"Bopage Janani","lastName":"Buddhika","suffix":""},{"id":378305963,"identity":"cfdd1203-1271-48ee-8a77-0ce0b808c220","order_by":1,"name":"Rana Weerasinghe Mudiyanselage Jayanthi Priyadarshani Jayasekera","email":"","orcid":"","institution":"The National Hospital, Kandy, Sri Lanka","correspondingAuthor":false,"prefix":"","firstName":"Rana","middleName":"Weerasinghe Mudiyanselage Jayanthi Priyadarshani","lastName":"Jayasekera","suffix":""},{"id":378305964,"identity":"f590c03b-4ccc-49f9-a31d-c7e625eccf1c","order_by":2,"name":"Nadeesha Dilmi Dias Wickramasinghe","email":"","orcid":"","institution":"Department of Pharmacy, Faculty of Health Sciences, The Open University of Sri Lanka, Nugegoda, Sri Lanka","correspondingAuthor":false,"prefix":"","firstName":"Nadeesha","middleName":"Dilmi Dias","lastName":"Wickramasinghe","suffix":""}],"badges":[],"createdAt":"2024-11-08 10:23:30","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5415780/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5415780/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":70170632,"identity":"3d8f632c-e765-4134-9ea8-9a210b79e770","added_by":"auto","created_at":"2024-11-29 06:33:39","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1204525,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5415780/v1/5445117d-61dd-4d2b-963f-4042bea8771d.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"State Hospital Pharmacists’ Knowledge, Attitudes, and Practices on Medication Counselling: A Multicenter Cross-sectional Study in Sri Lanka","fulltext":[{"header":"Background","content":"\u003cp\u003ePharmacists are generally more accessible than other healthcare professionals are and are often the final point of contact with patients before they begin taking their medications [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Pharmacists play a key role in ensuring positive outcomes in pharmaceutical care by educating and counselling patients, helping them adhere to their treatment plans, and monitoring schedules. Medication counselling is an important component of pharmaceutical care [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Medication counselling involves giving medication information either verbally or in writing to the patient or their caregivers, along with clear instructions on how to use the medication, information about potential side effects, proper storage, and recommendations on diet and lifestyle changes. This is typically accomplished through a direct, one-on-one interaction between the pharmacist and the patient or caregiver [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Medication counselling opportunities are key times for pharmacists to communicate with patients about their medications and the changes made to their treatments [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAccording to the revised International Pharmaceutical Federation (FIP) Basel Statements on the future of hospital pharmacies, \u0026ldquo;the overarching goal of hospital pharmacists is to optimize patient outcomes through collaborative, interprofessional, responsible use of medicines and medical devices\u0026rdquo;. Hospital pharmacists should serve as a resource for all aspects of medicine use and be accessible as a point of contact for patients and health care providers [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Medication counselling plays a crucial role in pharmacy practice [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Pharmacists are responsible for the treatment outcomes of their patients, and they can directly impact management outcomes by providing medication counselling to assist patients in the medication use process. Before dispensing medications, pharmacists should verify the accuracy of the drug supply at the counter. Pharmacists\u0026rsquo; counselling has improved health-related outcomes in many acute and chronic diseases [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ePatients who received pharmacist medication counselling before taking medication exhibited significantly better medication adherence than those who did not [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Pharmacist-mediated counselling promotes better knowledge, attitudes, and behaviours among patients, leading to more successful disease management. The \"Good Pharmacy Practice\" (GPP) guidelines of the National Medicine Regulatory Authority of Sri Lanka in 2019 specifically address the development of professional counselling strategies [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. As the last contact professional before the patient consumes medication, pharmacists have a role in checking for drug allergies, recalling the messages regarding the appropriate use of medicines, ensuring adequate monitoring, providing guidance on adverse drug effects as well as drug interactions, and improving patients' medication adherence [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. In Sri Lanka, the government is the primary healthcare supplier. It pays 50% of outpatient care and 95% of inpatient care, and almost all medical services are free at state hospitals. Pharmacists are essential members of healthcare teams who ensure that patients receive high-quality medical care. The purpose of this study was to assess state hospital pharmacists\u0026rsquo; knowledge, attitudes, and practices regarding medication counselling at public hospitals in Central Province, Sri Lanka.\u003c/p\u003e \u003cp\u003eIn Sri Lanka, integrating medication counselling into routine pharmaceutical services in state hospitals is still in its early stages, and there are limited data on how pharmacists perceive this role, how much knowledge they possess about effective medication counselling, and how frequently they engage in this practice. This multicentre cross-sectional study aimed to address this gap by assessing the knowledge, attitudes, and practices of state hospital pharmacists in Sri Lanka regarding medication counselling. By surveying pharmacists from multiple hospitals across different regions, this study provides a comprehensive overview of the factors that influence pharmacists\u0026rsquo; engagement in medication counselling, including their educational background, institutional support, and perceived barriers. Additionally, the study explores pharmacists\u0026rsquo; attitudes toward medication counselling, such as their perceived responsibility in ensuring medication safety and patient understanding.\u003c/p\u003e \u003cp\u003eThe findings from this research not only contribute to the literature on pharmacy practices in Sri Lanka but also offer valuable insights for healthcare policymakers, hospital administrators, and professional bodies. By identifying gaps in knowledge, attitudes, and practices, this study could inform future training programmes, continuing education initiatives, and policy reforms aimed at strengthening the role of pharmacists in patient care. Ultimately, improving pharmacists\u0026rsquo; engagement in medication counselling can lead to better patient outcomes, more efficient use of healthcare resources, and a stronger, more patient-centred healthcare system in Sri Lanka.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and setting\u003c/h2\u003e \u003cp\u003eThis study assessed hospital pharmacists\u0026rsquo; knowledge, attitudes, and practices regarding medication counselling at public hospitals in Central Province, Sri Lanka. A descriptive, cross-sectional, multicenter study was conducted in October 2022 in six state hospitals in the Central Province of Sri Lanka. All the hospital pharmacists working at state hospitals in the Central Province of Sri Lanka were considered to constitute the population. The Central Province has 3 districts, Kandy, Nuwara Eliya, and Matale, as the order of the highest population. The six state hospitals were selected for study through convenience sampling. Study Hospital 1 (SH1) is a national hospital and the largest hospital in the Central Province. Study Hospital 2 (SH2) is a teaching hospital, Study Hospital 3 (SH3) is the second largest children\u0026rsquo;s hospital in Sri Lanka, and Study Hospital 4 (SH4) is a base hospital. SH1 to SH4 were selected from the Kandy district. Study Hospital 5 (SH5) is a district hospital in Nuwara Eliya, and Study Hospital 6 (SH6) is a district hospital in the Matale district. The details of the selected hospitals and the number of pharmacists working at the selected state hospitals are shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDetails of the selected study hospitals\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelected hospitals for the study\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDistrict\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eType of hospital\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo. of beds\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNo. of pharmacists\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudy Hospital 1 (SH1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKandy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNational Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2492\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e78\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudy Hospital 2 (SH2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKandy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTeaching Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e957\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudy Hospital 3 (SH3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKandy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eChildren\u0026rsquo;s Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e342\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudy Hospital 4 (SH4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKandy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBase Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e357\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudy Hospital 5 (SH5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNuwara Eliya\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDistrict General Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1026\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudy Hospital 6 (SH6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMatale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDistrict General Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e825\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eStudy participants\u003c/h2\u003e \u003cp\u003eThe study cohort included hospital pharmacists working at 6 selected state hospitals. One hundred and sixty pharmacists were working at 6 selected hospitals (SH1, 78; SH2, 26; SH3, 16; SH4, 15; SH5, 10; SH6, 15).\u003c/p\u003e \u003cdiv id=\"Sec5\" class=\"Section3\"\u003e \u003ch2\u003eInclusion and exclusion criteria\u003c/h2\u003e \u003cp\u003ePharmacists who were working at selected state hospitals in Central Province, Sri Lanka, with more than three months of previous service experience as hospital pharmacists were included in the study. Pharmacy students, interns, and hospital pharmacists who were absent from their duties and those who declined to participate were excluded from the study.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eSampling method and technique\u003c/h2\u003e \u003cp\u003eAll the pharmacists working at the selected 6 hospitals were included in the study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eData collection\u003c/h2\u003e \u003cp\u003eA validated, self-administered questionnaire was used in this study to collect data on pharmacists\u0026rsquo; knowledge, attitudes, and practices related to medication counselling. The questionnaire was developed after reviewing previous similar surveys with some modifications. The questionnaire was subjected to a review and a validation process. The readability and understanding of the developed questionnaire were then verified among 16 randomly selected hospital pharmacists (10% of 160) working at different state hospitals with settings similar to those of the selected hospitals. Face validation of the questionnaire was carried out by colleagues from the inpatient department of SH1, and content validation was finalized by discussing the questionnaire with content experts of graduate hospital pharmacists, pharmacy academics, and a statistician. The internal consistency of the Likert scale questions of the questionnaire was measured by calculating Cronbach\u0026rsquo;s alpha value, which was found to be 0.71 for 8 questions on the Likert scale for measuring attitudes and 0.78 for 4 questions on the Likert scale for measuring practices, which means that there is acceptable reliability and consistency between the set of test items.\u003c/p\u003e \u003cp\u003eThe questionnaire consisted of four parts. The first part collected the demographic information of the participants, including five questions (age, sex, experience, educational background, and sections they had worked/or working). Participants were allowed to select multiple responses to the question on sections they had worked/or working at the hospital. The second part collected information on knowledge, including eight questions such as awareness of medication counselling, areas that should be covered in counselling, different information sources, and special patient conditions. The third section consisted of 10 questions on the attitudes of hospital pharmacists; 3 questions on professional development programmes, barriers to medication counselling, and appropriate strategies to overcome barriers were used, with two response options: \u0026ldquo;Yes\u0026rdquo; and \u0026ldquo;No\u0026rdquo;; and 7 questions with a 5-level Likert rating scale. The attitude dimension ranged from 1 \u0026ldquo;strongly agree\u0026rdquo; to 5 \u0026ldquo;strongly disagree\u0026rdquo;. The fourth part assessed current practices of counselling with two response options: \u0026ldquo;Yes\u0026rdquo; and \u0026ldquo;No\u0026rdquo;, multiple answer questions, single answer questions, and 4 questions with a 5-level Likert rating scale.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eEthical approval\u003c/strong\u003e \u003cp\u003e was obtained from the Ethics Review Committee at the Open University of Sri Lanka (FH/ERC/10). The questionnaire was developed in the English language and hand-delivered to the participants.\u003c/p\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eProcess of data collection\u003c/h2\u003e \u003cp\u003eData were collected in October 2022. After the approval of the relevant heads of the government hospitals was obtained, the chief pharmacists were informed about the study. The objectives of the study were explained. Written informed consent from the pharmacists was obtained, and they were assured that their participation in this study was voluntary and that their confidentiality would be maintained. The final data collection tool was distributed to pharmacists working at selected government hospitals in Central Province. Fifteen to thirty minutes were given to the respondents to complete and return the questionnaire to the investigator.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec10\"\u003e\n \u003ch2\u003eDemographic information\u003c/h2\u003e\n \u003cp\u003eOut of 160 hospital pharmacists, only 137 responded, and 119 questionnaires were analysed after 28 incomplete questionnaires were removed. The demographic characteristics are shown in Table \u003cspan\u003e2\u003c/span\u003e. There were more females (58.5%) than male participants. The highest professional qualification of the majority of the respondents was diploma in pharmacy (80.7%), which was offered by the Ministry of Health. A majority (68.9%) of the hospital pharmacists had over 10 years of experience. The participants were allowed to select multiple responses for the question on the working or working section. Among the 119 respondents, 83.2% reported the \u0026ldquo;Out Patients Department\u0026rdquo;, 54.6% responded to the \u0026ldquo;In Patients Department\u0026rdquo;, and 36.1% responded to the \u0026ldquo;Drug/Surgical Stores\u0026rdquo;. Twenty-four participants (20.2%) reported working or working in the \u0026ldquo;Counselling section\u0026rdquo;. Other categories reported by 21.8% of the respondents included \u0026ldquo;local purchase unit\u0026rdquo;, \u0026ldquo;cancer unit\u0026rdquo;, administration office, etc. [\u003cspan\u003e11\u003c/span\u003e]\u003c/p\u003e\n \u003cdiv\u003e\n \u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 2\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eDemographic characteristics of hospital pharmacists (N\u0026thinsp;=\u0026thinsp;119)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCharacteristics\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCategory\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003eAge (In years)\u003csup\u003e*\u003c/sup\u003e (N\u0026thinsp;=\u0026thinsp;118)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20\u0026ndash;29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30\u0026ndash;39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u0026ndash;49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;=50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMissing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eSex\u003csup\u003e*\u003c/sup\u003e (N\u0026thinsp;=\u0026thinsp;118)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e58.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMissing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eHighest educational qualification\u003csup\u003e*\u003c/sup\u003e (N\u0026thinsp;=\u0026thinsp;119)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDiploma in Pharmacy by Ministry of Health\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e80.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDegree in Pharmacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOther Degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePostgraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eDuration of service in the hospital\u003csup\u003e*\u003c/sup\u003e (N\u0026thinsp;=\u0026thinsp;119)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3 months to 1 year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1 to 5 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5 to 10 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMore than 10 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e68.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003eSections worked/or working\u003csup\u003e**\u003c/sup\u003e (N\u0026thinsp;=\u0026thinsp;119)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOut Patients Department\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e83.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIn Patients Department\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e54.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDrug/Surgical Stores\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCounselling section\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003e*\u003cem\u003ePercentages were calculated on the\u0026nbsp;\u003c/em\u003e\u003cem\u003ebasis of the\u0026nbsp;\u003c/em\u003e\u003cem\u003enumber of participants who responded to each demographic variable. Missing data are indicated where applicable.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e**Multiple responses were allowed for the question\u0026mdash;sections worked/or working. The sum of percentages may exceed 100%\u003c/em\u003e\u003cem\u003e,\u003c/em\u003e\u003cem\u003e\u0026nbsp;as participants were allowed to select more than one option.\u003c/em\u003e\u003c/p\u003e\n \u003cdiv\u003e\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec11\"\u003e\n \u003ch2\u003eKnowledge of hospital pharmacists on medication counselling\u003c/h2\u003e\n \u003cp\u003eMost of the pharmacists (99.2%) had heard that medication counselling is one of their responsibilities. Most pharmacists (97.5%) knew that the pharmacists themselves should be involved in medication counselling. A significant proportion of the pharmacists responded that physicians (73.1%) and nurses (66.4%) should also be involved in medication counselling. Regarding the sources of information used for updating knowledge, internet sources (94.1%) were the most popular choice. Formularies and guidelines (90.8%) and leaflets (83.2%) were also the primary sources used for updating the knowledge (Table \u003cspan\u003e03\u003c/span\u003e).\u003c/p\u003e\n \u003cdiv\u003e\n \u003ctable id=\"Tab4\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 03\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eSources of information used by state hospital pharmacists to update their knowledge (N\u0026thinsp;=\u0026thinsp;119)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSources of information\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFormularies and guidelines\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e90.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFriends\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e43.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInternet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e94.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOther members of the healthcare team\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e77.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDrug information bulletins\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e73.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBooks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e68.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLeaflets\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e83.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003eThe majority (86.4%) of the hospital pharmacists responded that they should update their knowledge \u0026ldquo;always\u0026rdquo;. Pharmacists were well aware of the type of information that should be provided during medication counselling (Table \u003cspan\u003e04\u003c/span\u003e). More than 90% of the participants responded that medication-related information such as names of medications, duration of treatment, precautions, special directions, common side effects, contraindications, and proper storage conditions should be provided during medication couselling. Other aspects, such as lifestyle changes and appropriate actions to be taken in the case of missed doses, were recognized by pharmacists to a lesser extent.\u003c/p\u003e\n \u003cdiv\u003e\n \u003cdiv align=\"left\"\u003eTable 4 State hospital pharmacists\u0026rsquo; knowledge of medication counselling\u003c/div\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"575\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePharmacists\u0026rsquo; knowledge on medication counselling\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eWhat information should be given to the patients during patient counselling?**\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDiagnosis of disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e33.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNames of the medications\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e111\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e93.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDuration of the treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e92.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePrecautions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e90.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSpecial directions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e114\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e95.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCommon side effects\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e114\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e95.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLifestyle changes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e84.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eContra-indications\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e94.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTherapeutic indication\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e61.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eProper storage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e113\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e95.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRefill information\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e62.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAppropriate actions to be taken in case of missed dose\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e101\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e84.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e2. What frequency pharmacists should update their knowledge on medication counselling?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAlways\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e86.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOften\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSometimes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003e\u003cem\u003e**Multiple responses were allowed for the question\u0026mdash;sections worked/or working. The sum of percentages may exceed 100%, as participants were allowed to select more than one option.\u003c/em\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec12\"\u003e\n \u003ch2\u003eAttitudes of hospital pharmacists toward medication counselling\u003c/h2\u003e\n \u003cp\u003eA significant majority (82.4%) of the pharmacists strongly agreed, and an additional 16.8% agreed, that counselling is part of their responsibilities. The responses to the statement \u0026quot;I would be embarrassed if I do not know how to answer questions from patients\u0026quot; were more varied; the majority were neutral (33.3%), whereas only 14.9% strongly agreed. A substantial proportion (57%) agreed that they should have allocated time for medication counselling, although this was split between strongly agreeing (39.5%) and agreeing (57.1%). A high proportion of the pharmacists reported enjoying medication counselling (43.7% strongly agree, 44.5% agree), and most believed that patients/guardians valued their counselling (23.1% strongly agree, 54.7% agree). Among the respondents, 78.2% strongly agreed that proper medication counselling can reduce medication misuse (Table \u003cspan\u003e5\u003c/span\u003e).\u003c/p\u003e\n \u003cdiv\u003e\n \u003ctable id=\"Tab6\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 5\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eState hospital pharmacists\u0026rsquo; attitudes towards medication counselling\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eStatement\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSA\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eA\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eD\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMode\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMedication counselling is a part of a pharmacist\u0026rsquo;s duty\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSA (82.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMedication counselling is a joint responsibility of both pharmacist and physician\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSA (50.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI should provide information regarding medications issued to patients regardless of waiting for the request of the patient for the information\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eA (47.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI should have allocated time for medication counselling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eA (57.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI would be embarrassed if I do not know how to answer questions from patients regarding their medications\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eN (33.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI enjoy medication counselling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSA (43.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePatients/guardians would like to get counselling from me\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eA (54.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eProper medication counselling will reduce the misuse of medications by patients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSA (78.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\"\u003e*SA\u0026thinsp;=\u0026thinsp;Strongly Agree, A\u0026thinsp;=\u0026thinsp;Agree, N\u0026thinsp;=\u0026thinsp;Neutral, D\u0026thinsp;=\u0026thinsp;Disagree, SD\u0026thinsp;=\u0026thinsp;Strongly Disagree\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003e**Mode: The response option selected by the majority for each statement.\u003c/p\u003e\n \u003cp\u003eOnline training was the preferred method for improving knowledge through continuous professional development programmes and was chosen by 76.5% of the pharmacists. Monthly seminars were the next preferred method, selected by 41.2% of the pharmacists. Weekend workshops and evening tutorials were less favoured, with 19.3% and 4.2% of the pharmacists choosing them, respectively, possibly owing to practical constraints on their availability.\u003c/p\u003e\n \u003cp\u003eThe primary barrier to effective medication counselling, which was responded to by 76.5% of the pharmacists, was the lack of time. Other commonly reported barriers included a shortage of pharmacists skilled in medication counselling (44.5%), limited patient awareness of pharmacists\u0026rsquo; counselling expertise (37.0%), low patient demand for counselling (34.5%), and lack of interest in counselling among some pharmacists (25.2%). To address these challenges, enhancing pharmacist knowledge of medication counselling and raising public awareness about pharmacists\u0026rsquo; counselling capabilities were identified as the top strategies by 63.9% and 53.8% of respondents, respectively. Additionally, other potential solutions included creating private consultation spaces within pharmacies (49.6%) and increasing pharmacy staffing (39.5%) to support more effective counselling services (Table \u003cspan\u003e06\u003c/span\u003e).\u003c/p\u003e\n \u003cdiv\u003e\n \u003ctable id=\"Tab7\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 6\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eState hospital pharmacists\u0026rsquo; attitudes towards continuous professional development courses and barriers to medication counselling.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePharmacists\u0026rsquo; attitudes of medication counselling\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e1. What are your preferred methods to improve knowledge from continuous professional development programmes?**\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMonthly seminars\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e41.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRegular classroom-type teaching\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWeekend workshops\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e19.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEvening tutorials\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOnline training\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e76.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e2. In your opinion, which of the following are barriers to medication counselling?**\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLack of patient awareness about pharmacist\u0026rsquo;s expertise in medication counselling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e37.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLack of pharmacist time for counselling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e76.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLack of pharmacists who are expertise in medication counselling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e44.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLack of patient demand for counselling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e34.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLack of pharmacist interest in counselling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e25.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e3. In your opinion, what are the appropriate strategies to overcome barriers for medication counselling?**\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIncrease public awareness about pharmacist\u0026rsquo;s ability for medication counselling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e53.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eImprove pharmacist\u0026rsquo;s knowledge about medication counselling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e63.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEstablish private consultation area in the pharmacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e49.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eImprove pharmacist\u0026rsquo;s communication skills\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e50.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIncrease staffing in pharmacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e39.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003e\u003cem\u003e**Multiple responses were allowed for the question. The sum of percentages may exceed 100%, as participants were allowed to select more than one option.\u003c/em\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec13\"\u003e\n \u003ch2\u003ePractices of hospital pharmacists on medication counselling\u003c/h2\u003e\n \u003cp\u003eThe majority of the pharmacists (92%) responded that they are engaged in medication counselling, whereas the rest of the pharmacists responded that they are working at surgical stores and other sections where direct patient contact was minimal. The study reported that a considerable number of pharmacists engaged in medication counselling (always 33%, frequently 35%). Among the 119 hospital pharmacists surveyed, 46.2% reported having printed materials to supply patients during counselling, whereas 45.4% indicated that they did not have such materials. The remaining ten respondents (8.4%) did not provide answers to this question.\u003c/p\u003e\n \u003cp\u003eAmong the 119 hospital pharmacists surveyed, 51.3% reported following established guidelines when counselling patients, whereas 42.9% indicated that they did not follow any specific guidelines. Seven respondents (5.9%) did not provide an answer to this question\u0026quot;. More than 80% of the participants reported that they provided information on the medication name, indication, route of administration, prescribed dose, frequency of administration, duration of treatment, and storage conditions. The majority (87.4%) of the participants reported that providing insufficient time for counselling was a challenge. Only 29.4% of the pharmacists claimed that hospitals offered training programmes to educate pharmacists about counselling. The study also revealed that pharmacists had different ways of improving their knowledge of medication counselling, with the majority (79.0%) preferring to use the internet, followed by continuing professional development (CPD) programmes outside of hospitals (45.4%), learning from senior pharmacy colleagues (39.5%), textbooks (47.9%), and other hospital staff (19.3%) (Table \u003cspan\u003e7\u003c/span\u003e).\u003c/p\u003e\n \u003cdiv\u003e\n \u003ctable id=\"Tab8\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 7\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003ePractices of hospital pharmacists during medication counselling\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003e1. What information is provided by pharmacists during medication counselling?**\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePharmacist\u0026rsquo;s practices during medication counselling\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eName of drug\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e89.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRoute of administration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e85.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDose of drug\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e89.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFrequency of administration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e89.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIndication\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e80.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDuration of therapy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e84.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDrug interactions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e73.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStorage conditions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e87.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGive written materials\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e64.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003e2. \u003cstrong\u003eWhat are the difficulties you face when medication counselling?**\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInsufficient time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e87.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInsufficient knowledge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI feel embarrassed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003e3. \u003cstrong\u003eHow you improve your knowledge related to medication counselling?**\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFrom continuous professional development courses outside of the hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFrom the training programs conducted at the hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFrom my senior pharmacy colleagues\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFrom other hospital staff (physicians, nurses)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFrom internet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e79.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFrom textbooks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e47.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003e4. \u003cstrong\u003eDo you have any printed materials to be supplied to patients when counselling?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e49.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003e5. \u003cstrong\u003eDo you follow any written guidelines when counselling?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e54.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003e6. \u003cstrong\u003eWhat are the difficulties you face when counselling?**\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInsufficient time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e87.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInsufficient knowledge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI feel embarrassed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003e7. \u003cstrong\u003eHow do you improve your knowledge related to counselling?**\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFrom continuous professional development courses outside of the hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFrom the training programs conducted at the hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFrom my senior pharmacy colleagues\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFrom other hospital staff (physicians, nurses)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFrom internet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e79.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFrom textbooks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e47.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003e\u003cem\u003e**Multiple responses were allowed for the question. The sum of percentages may exceed 100%, as participants were allowed to select more than one option.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eThe majority of the pharmacists agreed (25.8% strongly agree, 56.9% agree) that a high workload prevents them from engaging in medication counselling. More than half of the participants agreed that physicians appreciate their role in medication counselling, whereas 40.2% of the participants\u0026rsquo; responses were \u0026ldquo;neutral\u0026rdquo;. Eighty percent of the participants (25.6% strongly agree, 60.2%) agreed) accepted themselves as actively involved in medication counselling as part of the healthcare team. A major proportion of the pharmacists (22.9% strongly agree, 66.1% agree) reported that they engaged in medication counselling while dispensing medications, and no respondents disagreed (Table \u003cspan\u003e8\u003c/span\u003e).\u003c/p\u003e\n \u003cdiv\u003e\n \u003ctable id=\"Tab9\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 8\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eHospital pharmacists\u0026rsquo; engagement in medication counselling\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eStatement\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSA\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eA\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eD\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMode\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eA high workload prevents me from doing medication counselling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eA (56.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePhysicians appreciate that I am engaged in medication counselling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eA (45.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am engaged in medication counselling as a part of the healthcare team\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eA (60.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI do medication counselling while dispensing medication\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eA (67.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\"\u003e*SA\u0026thinsp;=\u0026thinsp;Strongly Agree, A\u0026thinsp;=\u0026thinsp;Agree, N\u0026thinsp;=\u0026thinsp;Neutral, D\u0026thinsp;=\u0026thinsp;Disagree, SD\u0026thinsp;=\u0026thinsp;Strongly Disagree\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003e**Mode: The response option selected by the majority for each statement.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe terms \"medication counselling\" and \"patient medication counselling\" often refer to interactions between pharmacists and patients focused on providing and discussing essential information about medications [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Pharmacist counselling is an intervention directed at patients\u0026rsquo; health-related needs, which also improves interprofessional and interinstitutional communication [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Offering counselling directly at the point of medication delivery in the pharmacy allows pharmacists to enhance medication safety and greatly improve patient adherence. The pharmacist is the primary source of general advice on medicines and health, and counselling aims to direct patients to use medications more safely and effectively [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Notably, to our knowledge, this is the first study in Sri Lanka assessing the knowledge, attitudes, and practices of pharmacists regarding medication counselling.\u003c/p\u003e \u003cp\u003eIn this study, the majority of the pharmacists\u0026rsquo; highest education qualification was the Diploma in Pharmacy offered by the Ministry of Health, Sri Lanka, which has a two-year diploma. In most countries, the basic requirement to practice as a hospital pharmacist is to have a degree in pharmacy [\u003cspan additionalcitationids=\"CR14\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. A majority of the hospital pharmacists in this study had over 10 years of experience, and similar findings were reported in a study conducted in Ohio [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. In another study conducted in Ethiopia on medication counselling by pharmacists, the majority of the pharmacists had 5 to 10 years of experience, while the proportion of those with more than 10 years of experience was minimal [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. A similar study conducted in Malaysia reported that only 9.7% of hospital pharmacists had more than 10 years of experience [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. The majority of the hospital pharmacists had either worked or were working at the \u0026ldquo;Out Patients Department\u0026rdquo;, where they dispensed medicines to the patients directly and engaged in medication counselling.\u003c/p\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eKnowledge of hospital pharmacists on medication counselling\u003c/h2\u003e \u003cp\u003eAlmost all the pharmacists in this study responded that medication counselling is one of their responsibilities and that the pharmacists themselves should be involved in medication counselling, indicating a high level of self-awareness and responsibility for the role of counselling. Similar findings have been reported from a study conducted on the attitudes and behaviours of community pharmacists on medication counselling in India, \u0026ldquo;as medication counselling is a professional obligation\u0026rdquo; [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Additionally, the pharmacists responded that other healthcare team members, such as physicians and nurses, should also be involved in medication counselling, highlighting the importance of a multidisciplinary approach to patient care.\u003c/p\u003e \u003cp\u003eHospital pharmacists are strongly committed to continuous professional development, with the majority indicating that they believe that they should \"always\" update their knowledge. The most widely used resource for updating information on medication counselling was reported as an internet source, reflecting the growing importance of online resources in the healthcare field. Formularies, guidelines, and leaflets were reported as the second and third most commonly used sources for updating knowledge in this study. A study conducted in Nigerian reported reference books such as the British National Formulary, the internet, and drug information leaflets as the most commonly used sources for knowledge updates for medication counselling [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMoreover, the pharmacists demonstrated a clear understanding of the type of information that should be provided during medication counselling, ensuring that patients receive relevant details to support medication adherence and understanding. A vast majority of the pharmacists responded that they provide names of medications, durations of treatment, precautions, special directions, common side effects, contraindications, and proper storage conditions during medication counselling. A study conducted in Ethiopia reported that information on the frequency of administration, route of administration, dose of drugs, and duration of therapy was the most common form of drug information given during medication counselling by pharmacists [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Some countries have medication counselling guidelines developed for pharmacists to ensure that all patients receive the most important information [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eAttitudes of hospital pharmacists toward medication counselling\u003c/h2\u003e \u003cp\u003eThis study reported a strong commitment among pharmacists to medication counselling as an integral aspect of their duties. This aligns with global research indicating that pharmacists widely recognize medication counselling as an essential component of their professional role. Studies in both developed and developing countries have reported similar findings, where pharmacists view patient education and counselling as critical to ensuring medication safety and adherence [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e Pharmacists\u0026rsquo; responses were more varied regarding statements about being embarrassed if unable to answer patients\u0026rsquo; questions, with only 14.9% strongly agreeing and a majority remaining neutral (33.3%). This reflects potential uncertainty or variability in pharmacists\u0026rsquo; confidence levels when handling complex or unexpected queries. A lack of pharmacists\u0026rsquo; confidence in counselling was reported by only 6.4% of hospital pharmacists in Ohio, USA [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. The findings suggest that the development and introduction of training programmes in communication skills and continuous professional education may help pharmacists feel more confident in patient interactions.\u003c/p\u003e \u003cp\u003eThe desire for dedicated time for medication counselling is a critical finding, with a substantial proportion supporting the idea, either strongly agreeing or agreeing. Time constraints have been frequently cited as a barrier to effective counselling in various settings, as pharmacists are often burdened by competing responsibilities that limit their capacity for in-depth interactions with patients [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Providing pharmacists with allocated time and a dedicated area for counselling could significantly enhance the quality and depth of patient education, supporting the trend towards more patient-centred pharmacy practice seen in other research.\u003c/p\u003e \u003cp\u003eA high proportion of pharmacists enjoy medication counselling and believe that patients value this service. This is supported by the findings of a study conducted in Belgium where pharmacists reported that patients needed to tell their stories and discuss how they would manage medicines when returning home [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. The satisfaction derived from medication counselling suggests that many pharmacists find personal and professional fulfilment in these interactions. Additionally, the belief that patients value their counselling services reflects positively on the pharmacist-patient relationship, fostering trust and reinforcing the role of pharmacists as essential healthcare providers. A high level of patient satisfaction with medication counselling is reported in terms of the amount of information received as verbal and written information about their medication [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe majority of respondents in this study strongly agreed that effective medication counselling could reduce medication misuse. This finding resonates with other research highlighting the positive impact of pharmacist-patient interactions on reducing medication errors and misuse. According to previous studies, comprehensive counselling on medication use, potential side effects, and adherence strategies significantly reduce the risk of adverse drug events and noncompliance [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Pharmacists\u0026rsquo; understanding of the value of counselling is crucial for their engagement with patients, as effective counselling has been shown to improve both clinical outcomes and patient safety [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ePharmacists worldwide use continuing education (CE) or continuing professional development (CPD) to stay current with knowledge and skills throughout their careers [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. In this study, more than 75% of participants preferred online CPD programmes, whereas in a study conducted among Lebanese hospitals, pharmacists (60.6%) also preferred computer-based CPD programmes [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Monthly seminars were also preferred, suggesting a willingness to engage in face-to-face learning opportunities.\u003c/p\u003e \u003cp\u003eA lack of time for medication counselling was identified as the most significant barrier to medication counselling, chosen by a majority (76.5%) of the pharmacists. This suggests that time constraints in a busy pharmacy environment can hinder the provision of comprehensive patient counselling services. A focus group study conducted among hospital pharmacists in Australia also reported that time pressure caused by the hospital was a major challenge for medication counselling at hospitals [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. This finding is supported by a cross-sectional survey conducted in Saudi Arabia among community pharmacists, which reported that a common barrier for pharmacists in providing counselling to patients was a lack of time due to their other responsibilities [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Workload and time limitations are frequently reported as obstacles to effective medication dispensing and patient counselling in various areas [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ePharmacists have various resources available to improve communication with patients, particularly those who face health literacy challenges [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Enhancing the knowledge and communication abilities of pharmacists was seen as vital for overcoming counselling barriers. Increased public awareness of the pharmacist's ability for medication counselling was identified as an important strategy by 54% of the pharmacists. These findings indicate that patient engagement and understanding of the pharmacist's role in counselling can positively impact counselling opportunities.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003ePractices of hospital pharmacists on medication counselling\u003c/h2\u003e \u003cp\u003eProper dispensing practices ensure that the correct medication, in an effective form and appropriate dosage, is provided to the right patient in the right quantity, with clear instructions and packaging that preserves the drug\u0026rsquo;s potency [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. In Brazil, as per the regulations, dispensing includes \u0026ldquo;the pharmacist\u0026rsquo;s role in providing instructions, medications, and medicinal products to a patient, as a remunerated work or not\u0026rdquo; [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. In most regions, only pharmacists have the authority and responsibility to dispense medications, although some also allow doctors and/or nurses to perform this role. Medication counselling is an essential part of the dispensing process, providing patients with the necessary information to understand their medications and their intended therapeutic effects. Patients should always be encouraged to ask questions and seek clarification on any details [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. The fact that 85% of the pharmacists reported counselling during dispensing highlights the strength of existing practices. This suggests that patient interactions during dispensing were viewed as an opportune moment for counselling, although some (9%) may find it challenging to engage fully during this time. In some countries, counselling via telephone has resulted in improved patient adherence [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWhile more than half of the pharmacists felt appreciated by physicians, a substantial number remained neutral. Similarly, 8.9% of the physicians were not sure about the need for counselling by a pharmacist [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. The findings of this study indicate a lack of communication or formal acknowledgement of the pharmacist's role in medication counselling within the healthcare team. Physicians, pharmacists, and nurse trios have been identified as members of multidisciplinary drug review teams [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. This study revealed that most pharmacists perceived themselves as integral to medication counselling within the healthcare team, indicating that their role in this area is well established. The small percentage of disagreement suggests that a minority may feel excluded or lack formal integration into the team\u0026rsquo;s counselling efforts.\u003c/p\u003e \u003cp\u003eLowering the dispensing workload may allow pharmacists time to review prescriptions and help reduce dispensing errors [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. The overwhelming agreement (80%) that workload prevented medication counselling indicated a critical area for improvement. Similar findings were reported in other studies in which workload negatively affected medication counselling [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. This could imply a need for workflow improvements or additional staffing to allow pharmacists more time for patient interactions [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAmong the 119 hospital pharmacists surveyed, 46.2% reported providing printed materials to patients during medication counselling. A study conducted in a rural district in Sri Lanka among chronic kidney disease (CKD) patients reported that counselling sessions led by a trained clinic-based pharmacist providing written drug and disease information, along with verbal education in local languages, helped enhance drug and disease knowledge for patients with CKD [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. In addition to printed material, including written information, pictograms are also used in medication counselling. Some studies have shown no significant effect of pictogram-based counselling when caregivers already possess adequate literacy levels [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. However, other studies suggest that both types of caregivers with low literacy levels and those with high literacy levels may benefit from pictogram-assisted counselling approaches [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. The findings of this study indicate that there is almost an even split between pharmacists who have printed materials available for medication counselling and those who do not. Furthermore, while a slight majority of hospital pharmacists follow established guidelines when counselling patients, a significant proportion (42.9%) do not adhere to any formal guidelines. This variation in practice may affect the consistency and quality of patient counselling provided by pharmacists. These gaps highlight the potential need for healthcare institutions to provide standardized educational materials, which can enhance the quality and consistency of medication counselling provided by pharmacists.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eLimitations of the study\u003c/h2\u003e \u003cp\u003eThis study investigated only the knowledge, attitudes, and practices related to medication counselling at six government hospitals in Central Province. Assessing these parameters at other hospitals in the central province would be more representative. Furthermore, assessing the awareness of other healthcare members on medication counselling by pharmacists would be highly valuable. Moreover, the study did not examine patients\u0026rsquo; perceptions of medication counselling by hospital pharmacists.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eHospital pharmacists in the Central Province of Sri Lanka have a strong understanding of medication counselling and its importance. Further studies are suggested to identify suitable approaches to enhance medication counselling conducted at state hospitals.\u003c/p\u003e \u003cp\u003eA notable majority of the participants had over ten years of experience and held a diploma in a pharmacy, with many working primarily in outpatient departments. Pharmacists showed a strong awareness of their responsibilities in medication counselling and favoured continuous knowledge updates, predominantly via internet sources. The results indicate a positive attitude towards medication counselling, with most pharmacists recognizing its value in reducing medication misuse. However, barriers such as high workload and limited time are commonly reported, restricting the ability to engage in medication counselling effectively. Strategies such as implementing private consultation areas, increased staffing, and structured training programmes are recommended to address these obstacles. Providing training and guidelines for medication counselling and initiating policy decisions to facilitate medication counselling by pharmacists are recommended. Furthermore, the pharmacist\u0026rsquo;s knowledge, communication skills, and public awareness of the pharmacist's role should be improved.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eSH: Study Hospital 1; CE: Continuing Education; CPD: Continuing Professional Development; CKD: Chronic Kidney Disease\u003c/p\u003e\n"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Ethics Review Committee of the Open University of Sri Lanka approved the study (FH/ERC/10). Administrative approval was obtained from the directors of the relevant state hospitals. All methods were performed following relevant guidelines and regulations. The data were kept confidential and were only used for the intended purpose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe consent to publish the information gathered from the state hospitals was obtained from the heads of the relevant hospitals. The data are reported such that it will not be possible to identify the individual institutions.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe questionnaire and datasets analysed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eCompeting interests:\u0026nbsp;\u003c/strong\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was self-funded.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eRBJB and JRWMJP conceived the idea of the study, and all the authors participated in designing the study. JRWMJP was involved in the data collection. RBJB, JRWMJP and NDDW were involved in the analysis and interpretation of the data. RBJB, JRWMJP, and NDDW drafted the manuscript, and RBJB, JRWMJP, and NDDW critically revised it. All the authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAcknowledgements\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to express our gratitude to the hospital pharmacists working at state hospitals in the central province for their cooperation during data collection.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003eDepartment of Pharmacy, Faculty of Health Sciences, The Open University of Sri Lanka, Nugegoda, Sri Lanka, \u003csup\u003e2\u003c/sup\u003eDistrict General Hospital, Kandy, Sri Lanka\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eInformed consent:\u003c/strong\u003e Informed written consent was obtained from the hospital pharmacists in this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eTsuyuki, R.T., Beahm, N.P., Okada, H., Al Hamarneh, Y.N.: Pharmacists as accessible primary health care providers: Review of the evidence, (2018)\u003c/li\u003e\n\u003cli\u003eHeplhr, C.D., Strand, L.M.: Opportunities and responsibilities in pharmaceutical care. 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Pediatr Neonatol. 54, 34\u0026ndash;42 (2013). https://doi.org/10.1016/j.pedneo.2012.10.002\u003c/li\u003e\n\u003cli\u003eTork, H.M.M.: A Pictogram-Based Intervention to Reduce Parental Liquid Medication Errors: Health Literacy Approach. American Journal of Nursing Science. 2, 27 (2013). https://doi.org/10.11648/j.ajns.20130203.12\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"knowledge, attitudes, practices, medication counselling, pharmacists, hospitals, Sri Lanka","lastPublishedDoi":"10.21203/rs.3.rs-5415780/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5415780/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eMedication counselling is an essential element of health care, particularly in pharmacy practice, as it promotes adherence to medications and minimizes adverse effects. Hospital pharmacists play a crucial role in pharmaceutical care by ensuring that patients use medications safely and effectively. In Sri Lanka, the role of hospital pharmacists is largely restricted to dispensing medications, providing limited drug information, managing pharmaceutical inventories, and compounding extemporaneous preparations within hospital settings. This study aimed to evaluate the knowledge, attitudes, and practices of pharmacists regarding medication counselling in government hospitals in the Central Province of Sri Lanka.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA cross-sectional study was conducted in October 2022 across six state hospitals in the Central Province of Sri Lanka. A validated self-administered questionnaire was given to 160 hospital pharmacists to gather demographic details and assess their knowledge, attitudes, and practices related to medication counselling. The collected data were analysed via IBM SPSS software (version 25), and descriptive statistical methods were applied.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eOf the 160 pharmacists, 119 responded to the questionnaire. A majority (99.2%) affirmed that medication counselling is a core responsibility, with 97.5% reporting their active involvement in this task. Notably, 92% were engaged in counselling activities, and 68.9% had more than a decade of experience. While most respondents acknowledged the importance of providing complete medication information, more than 80% routinely discussed essential details such as medication names, indications, administration routes, dosages, frequencies, treatment durations, and storage guidelines. The identified barriers to effective counselling included time constraints (87%), limited knowledge (67%), lack of updated drug information (67%), and heavy patient loads (82%). Online training was preferred for professional development.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eState hospital pharmacists actively participated in medication counselling and exhibited positive attitudes towards it. Many were open to seeking further knowledge to improve service quality. However, significant obstacles remain, such as time limitations, a lack of updated knowledge, and high patient demand. To address these issues, it is recommended that policymakers, hospital administrators, and pharmacists collaborate on strategies to strengthen medication counselling services, including the establishment of standard guidelines and patient education initiatives.\u003c/p\u003e","manuscriptTitle":"State Hospital Pharmacists’ Knowledge, Attitudes, and Practices on Medication Counselling: A Multicenter Cross-sectional Study in Sri Lanka","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-11-29 06:25:32","doi":"10.21203/rs.3.rs-5415780/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-11-14T20:49:54+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-11-12T12:17:11+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-11-12T12:15:35+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Health Services Research","date":"2024-11-08T10:10:18+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a6f22bcf-34df-4a0e-aba6-bb07a2ac5b33","owner":[],"postedDate":"November 29th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-11-24T10:23:29+00:00","versionOfRecord":[],"versionCreatedAt":"2024-11-29 06:25:32","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5415780","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5415780","identity":"rs-5415780","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}