THE PROVISION OF PHARMACEUTICAL CARE IN OMAN: 
            PRACTICE AND PERCEIVED FACILITATORS AND BARRIERS 
                           TO IMPLEMENTATION 
                                   by         
                              Awatif Al Abdullatif 
                     A thesis submitted in conformity with the requirements 
                          for the degree of Doctor of Philosophy 
                         Department of Pharmaceutical Sciences 
                              University of Toronto 
                        © Copyright by Awatif Al Abdullatif (2014) 
                                     
           
                                     
                         ABSTRACT 
        The Provision of Pharmaceutical Care in Oman: Practice and Perceived Facilitators and Barriers 
                        to Implementation 
                        Awatif Al Abdullatif                                                                                                                                     
                        Doctor of Philosophy                                                                                                                     
                    Department of Pharmaceutical Sciences 
                        University of Toronto                                                                                                                                           
                           2014 
                             
        Objectives: The study purpose was to determine the extent of the implementation of 
        pharmaceutical care (PC) in Oman and factors affecting its implementation.  
        Methods: A cross-sectional mail survey of all practicing pharmacists in Oman based on the 
        Theory of Planned Behavior (TPB) was conducted. The survey instrument was informed by a 
        focus group study to identify behavioral, normative, and control beliefs amongst pharmacists in 
        three practice settings: inpatient, outpatient, and community pharmacy.  
        Results: The survey useable response rate was 61.2%. Participants provided PC activities 
        between ‘sometimes’ and ‘most of the time’; however, provision of advanced PC activities was 
        limited. Provision of PC did not significantly differ across inpatient, outpatient, and community 
        settings. Clinical knowledge, communication skills, pharmacist time, and adequate staffing were 
        common facilitators across practice settings; worry about responsibility and culturally-based 
        gender issues regarding patient care were common barriers. While having a private counseling 
        area, and access to patient records and to drug information databases were facilitators identified 
        in the public sector, their absence was a barrier in community pharmacies. Reimbursement was 
        the main barrier in the private sector. Country of origin was significantly related to pharmacists’ 
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        beliefs about providing PC; specifically, Omani pharmacists had significantly different 
        behavioral, normative, and control beliefs than their South Asian counterparts. All constructs of 
        the TPB (attitude, subjective norm, and perceived behavioral control) were significant predictors 
        of intention to provide PC, but the added construct—past behavior recency was not. The overall 
        variance explained in intention was 43%. Of the two predictors of behavior in the TPB model, 
        only perceived behavioral control was significant; intention was not. The explained variance in 
        PC behavior was 13.0%. 
        Conclusions: This is the first study to examine the implementation of PC in Oman. The findings 
        of this study will inform the development of strategies for advancing PC practice, a mandate of 
        Ministry of Health and the pharmacy profession in Oman. The TPB was useful for explaining 
        pharmacists’ intention to provide PC; however, a longitudinal study is recommended to test its 
        predictive validity for PC behavior. 
                      
         
         
         
         
         
         
         
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                      ACKNOWLEDGEMENTS 
         
        I would like to express my gratitude to all of those who have helped me accomplish my studies 
        and this insurmountable venture. Firstly, I would like to thank Dr. Linda MacKeigan, for it was 
        under her guidance and wisdom, without which this thesis would not have been possible. She 
        continued to stand by me and offer continuous feedback to ensure the quality of work delivered 
        is of a high calibre. I also extend my utmost thanks to the members of the Advisory Committee; 
        Dr. Joan Marshman and Dr. Rhonda Cockerill. Their addition of perspective and sage advice 
        enabled me to further improve the quality of my work.    
        Similarly, I would like to thank H.E. Minister of Manpower Mohamed Al Bakri, and former 
        Minister of Manpower H.E. Juma Ali, for making all of this possible in the first place by 
        granting me this scholarship. Additional thanks goes to the Site Advisory Committee in Oman 
        that consisted of Mrs. Sawsan Ahmed Jaffer, Dr. Ibrahim Al Zakwani, Mrs. Jehan Alfanna, Mr. 
        Qasim Al Riyami, Dr. Bryan Gunn, Mr. Osama Babiker, and Mr. Bakool Mehta. Their support in 
        providing me with the information and data necessary was pivotal to my research.  
        I am also very thankful to the funding agencies that helped me finance my expenses and allowed 
        me to carry out the necessary set ups to conduct my research; namely, the Ministry of 
        Manpower, Oman, Muscat pharmacy for sponsoring the survey study, and Oman Pharmaceutical 
        Products (OPP) for sponsoring the focus group study. 
        Along with every venture, there come several points in time where we require additional moral 
        support and motivation to continue soldiering on. For those moments, I take this opportunity to 
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