For US pharmacists (all sectors, including community), work overload was one of the factors that most contributed to job stress for pharmacists generally.[55] Other US research suggested that community pharmacists wanted to spend less time dispensing and on business management and more time on consultation and drug-use management. This was true of community pharmacists working in both chain and independent pharmacy settings.[56] Results from another study showed that prescriptions Target Selective Inhibitor Library molecular weight dispensed personally by community pharmacists had increased since

the year 2000.[57] Svarstad et al. also reported that increased community pharmacy busyness reduced the likelihood of any pharmacist

communication to patients (talking to patients, oral information giving, assessment of understanding).[58] Papers identified used a range of methods to research the subjects of pharmacist workload, job satisfaction and stress. Various limitations are to be noted. Two studies used questionnaires to collect information from pharmacists.[43,46] Questionnaires in all the studies identified were previously validated. However, non-response bias has the potential to affect study outcomes on the basis that non-responders may be characteristically different to Selleckchem Forskolin those who do respond. McCann et al. stated that non-response bias in their quantitative study[46] (questionnaire response rate 39%) should not be overlooked. Bond et al. followed up non-responders over the telephone, giving a high overall response rate (71%) helping to reduce

possible bias.[43] The use of work diaries or subjective evaluation as a method of recording pharmacists’ work patterns was reported by several of the studies identified. Participants’ perception of time spent on certain aspects of their jobs was skewed, intentionally or unintentionally. One study reported differences between actual work completed and estimated work, some of the differences having statistical significance.[39] Observational studies were used in some of the research described in this review. Observations are subject to the Hawthorne effect, where participants modify their behaviour in response to being observed.[59] Immune system Although quantifying the Hawthorne effect in such studies remains difficult, observations are still key for investigating pharmacists’ workload, especially given the differences in perceived workload and actual workload identified in this review.[39] Much of the data presented in this review were collected several years prior to the introduction of the 2005 CPCF in England and Wales. Only seven out of the 13 studies identified were post 2005; three of these were in Northern Ireland where the contractual framework is different to England and Wales.