BARRIERS TO COMPLIANCE WITH OBRA90 REGULATIONS IN COMMUNITY PHARMACIES

OBJECTIVE: To identify which barriers have been most significant to co mmunity pharmacists in their ability to comply with the Omnibus Budget Reconciliation Act of 1990 (OBRA'90) regulations during its first yea r of implementation. METHODS: Mailing of a two-page survey in April 19 94. SETTING: Four hundred randomly selected community pharmacies in th e Commonwealth of Massachusetts. PARTICIPANTS: Of 400 pharmacies surve yed, 156 surveys were completed and returned for analysis. RESULTS: Ba rriers that were considered most significant to pharmacies surveyed in their ability to implement OBRA'90 regulations were excessive workloa d, lack of financial compensation, and patients' attitudes. Of least s ignificance were inadequate knowledge about drugs, inadequate referenc es, and store layout. Almost half the responding pharmacists indicated that OBRA'90 regulations had not affected or changed their practice, one-quarter of the pharmacists believed their practice was less reward ing after OBRA'90, and about one-fifth believed it was more rewarding. CONCLUSIONS: Community pharmacists in Massachusetts are making an att empt to comply with OBRA'90, but there are specific barriers that are affecting their ability to do so. The OBRA'90 regulations appear to ha ve had little impact on the practice of most community pharmacies. Com munity pharmacy management needs to examine (I) expanded roles of supp ortive personnel to give pharmacists more time to spend counseling pat ients, (2) reimbursement mechanisms for cognitive service, and (3) app roaches to educating patients about these changes in the pharmacy prof ession.