Barriers to providing cognitive services.

Seventy-three pharmacists were surveyed to evaluate their perceptions of barriers to performing cognitive services in community pharmacy; 64 responded. Perceived barriers to counseling patients were excessive workload, lack of privacy, patient attitudes, and store layout. Perceived barriers to interacting with physicians were difficulties contacting them, negative physician attitudes toward pharmacists' recommendations, excessive workload, and inadequate patient information. Rates of interaction with prescribers correlated with greater job satisfaction; rates of patient counseling did not. Methods to address these barriers include structuring reimbursement and workload around cognitive services rather than drug product dispensing, redesigning pharmacies to provide counseling areas, changing attitudes and abilities through pharmacist education, and using technology to promote information transfer between pharmacies and health care facilities.