• Nazri Nordin School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Minden, Pulau Pinang, Malaysia
  • Mohamed Azmi Ahmad Hassali School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Minden, Pulau Pinang, Malaysia
  • Azmi Sarriff School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Minden, Pulau Pinang, Malaysia



STARZ-DRP, Community pharmacists, Triage decision, Stakeholders, Malaysia


Objective:  To investigate perspectives and expectations of stakeholders of community pharmacists' (CPs) roles and the use of STARZ-DRP as a structured and systematic framework to help CPs to extend their role to make an accurate triage decision in community pharmacy settings.

Methods: Individuals who were in high positions in the Ministry of Health (MOH), pharmacy, medical and consumer associations and individuals who were a private medical practitioner and retail pharmacist were invited via mail to participate in the face to face interview. The interviews were audio-taped and transcribed verbatim to identify themes as many as possible.

Results: Eight stakeholders had responded to the invitation. Mean (± standard deviation) age (years) of stakeholders was 56.50 ± 11.82. Five themes were noted which were: (i) CPs are focusing more on business-oriented, (ii) CPs should perform patient-oriented services, (iii) responsibilities to triage customers, (iv) a systematic approach for triaging activities, (v) STARZ-DRP as a systematic approach to making triage decision.

Conclusion: CPs are paying particular attention on business-oriented than patient-oriented services. All stakeholders point out that CPs should intensify their current practice and all of them have the same opinion that CPs should take the responsibilities to make an accurate triage decision for self-care customers. Almost all stakeholders agree that STARZ-DRP is an ideal framework to help CPs to make an accurate triage decision in community pharmacy settings.



Download data is not yet available.


Covington TR. Non-prescription medications and self-care. Non-prescription drug therapy: issues and opportunities. Am J Pharm Educ 2006;70:137.

Major C, Vincze Z, Mesko A, Balogh J, Zelko R, Nemeth E. Medicating outside the consulting room. Orv Hetil 2007;148:291-8.

Smith M, Bates DW, Bodenheimer T, Clearly PD. Why pharmacists belong in the medical home. Health Affair 2010;29:906-13.

Afolabi AO, Akinmoladun VI, Adebose IJ, Elekwachi G. Self-medication profile of dental patients in ondo State, Nigeria. Nig J Med 2010;19:96-103.

Wen Y, Lieber E, Wan D, Hong Y. A qualitative study about selfâ€medication in the community among market vendors in Fuzhou, China. Health Soc Care Comm 2011;19:504-13.

Hussain A, Khanum A. Self medication among university students of Islamabad, Pakistan-a preliminary study. Southern Med Rev 2008;1:14-6.

Wallace JL. How do NSAIDs cause ulcer disease? Baillieres Best Pract Res Clin Gastroenterol 2000;14:147-59.

Horiuchi T, Nakamura M, Tsuchiya T. Contribution of the pharmacists to self-care and primary care with nonprescription medications. Yakugaku Zasshi 2010;130:1623-7.

Sing WS. Pharmacy practice in Malaysia. Mal J Pharm 2001;1:2-8.

Rajiah K, Kaur KP, Sivarasa S, Ming LY. Perception of community pharmacists towards patient counselling and continuing pharmacy education program in Kuala Lumpur and Selangor states of Malaysia. Am J Pharm Health Res 2014;2:48-56.

Hassali MA, Subish P, Shafie AA, Ibrahim MIM. Perceptions and barriers towards the provision of health promotion activities among community pharmacists in the state of penang, Malaysia. J Clin Diagn Res 2009;3:1562-8.

Beshir SA, Hanipah MA. Knowledge, perception, practice and barriers of breast cancer health promotion activities among community pharmacists in two districts of selangor State, Malaysia. Asian Pacific J Cancer Prev 2012;13:4427-30.

Holland R. When to Refer. Pharmaceutical Society of Australia. Pharmaceutical Society of Australia; 1993. p. 15.

Keegan J. The Face of Battle. New York: Viking Press; 1976. p. 267-9.

Sarriff A, Nordin N, Hassali MA. STARZ-DRP: a step-by-step approach for pharmacy triage services. Mal J Pharm 2011;1:311-25.

Nazri N. Establishing pharmaceutical care service to customers presenting symptoms of minor ailments in community pharmacies in Seberang Prai, Pulau Pinang: a feasibility study. (Thesis) 2014. p. 69-72.

Hoddinott SN, Bass MJ. The dillman total design survey method. Can Fam Physician 1986;32:2366–8.

Creswell JW, Fetters MD, Ivankova NV. Designing mixed methods study in primary care. Ann Fam Med 2004;2:7-12.

Azmi S, Nazri N, Azmi AH. Extending the roles of community pharmacists: views from general medical practitioners. Med J Malaysia 2012;67:574-8.

Hassali MA, Awaisu A, Shafie AA, Saeed MS. Professional training and roles of community pharmacists in Malaysia: views from general medical practitioners. Malays Fam Physician 2009;4:71-6.

Saw PS, Nissen LM, Freeman C, Wong PS, Mak V. Health care consumers’ perspectives on pharmacist integration into private general practitioner clinics in Malaysia: a qualitative study. Patient Prefer Adherence 2015;9:467–77.

Rayes IK, Hassali MA, Abduelkarem AR. The role of pharmacists in developing countries: the current scenario in the United Arab Emirates. Saudi Pham J 2015;23:470-4.

Rayes IK, Hassali MA, Abduelkarem AR. Perception of community pharmacists towards the barriers to enhanced pharmacy services in the healthcare system of Dubai: a quantitative approach. Pharm Pract 2015;13:506.

Wong FYY, Chan FWK, You JHS, Wong ELY, Yeoh EK. Patient self-management and pharmacist-led patient self-management in Hong Kong: a focus group study from different healthcare professionals’ perspectives. BMC Health Serv Res 2011;11:121.

George PP, Molina JAD, Cheah J, Chan SC, Lim BP. The evolving role of the community pharmacist in chronic disease management–a literature review. Ann Acad Med Singapore 2010;39:861-7.

Laliberte MC, Perreault S, Damestoy N, Lalonde L. Ideal and actual involvement of community pharmacists in health promotion and prevention: a cross-sectional study in Quebec, Canada. BMC Public Health 2012;12:192.

Salim AM, Elgizoli B. Exploring self-perception of community pharmacists of their professional identity, capabilities and role expansion. J Res Pharm Pract 2016;5:116-20.

Egorova SN, Akhmetova T. Pharmaceutical counselling: between evidence-based medicine and profits. Int J Risk Saf Med 2015;27 Suppl 1:87-8.

Fang Y, Yang S, Zhou S, Jiang M, Liu J. Community pharmacy practice in China: past, present and future. Int J Clin Pharm 2013;35:520-8.

Berbatis CG, Sunderland VB, Joyce A, Bulsara M, Mills C. Enhanced pharmacy services, barriers and facilitators in Australia's community pharmacies: Australia's National Pharmacy Database Project. Int J Pharm Pract 2007;15:185-91.

Scheerder G, De Coster I, Van Audenhove C. Pharmacists’ role in depression care: a survey of attitudes, current practices, and barriers. Psychopharmacol Serv 2008;59:1155-61.

Khairunnisa, Nasution A. Pharmacists’ perception about their roles in tuberculosis control program in Medan, Indonesia. Asian J Pharm Clin Res 2017;10:256-8.

Sushilkumar PL, Mahendrakumar BJ, Baishnab S, Gloria Sam K, Chaitanya Kumar T. Implementation and evaluation of health screening services to diabetic and hypertensive patients in a selected community pharmacy at Belgaum City. Asian J Pharm Clin Res 2015;8:305-15.

Warchal S, Brown D, Tomlin N, Portlock J. Attitudes of successful candidates of supplementary prescribing courses to their training and their extended roles. Pharm J 2006;276:348-52.

Hoti K, Hughes J, Sunderland B. An expanded prescribing role for pharmacists–an Australian perspective. Aust Med J 2011;4:236-42.

Malangu N. The future of community pharmacy practice in South Africa in the light of the proposed new qualification for pharmacists: implications and challenges. Global J Health Sci 2014;6:226-33.

Sadek MM, Elnour AA, Al Kalbani NMS, Bhagavathula AS, Baraka MA, Aziz AMA, et al. Community pharmacy and the extended community pharmacist practice roles: The UAE experiences. Saudi Pharm J 2016;24:563-70.

Blenkinsopp A, Paxton P, Blenkinsopp J. Symptoms in the pharmacy: a guide to the management of common Illness. 5th Eds. Blackwell Publishing, Oxford UK; 2005. p. 1-13.

Edwards C, Stillman P. Minor illness or major disease? The clinical pharmacist in the community. 4th Eds. Pharmaceutical Press London; 2006. p. 1-10.

Rutter P. Community pharmacy. Symptoms, Diagnosis and Treatment. Churchill Livingstone. An Imprint of Elsevier Limited; 2004. p. 9–11.

Rutter PM, Horsley E, Brown DT. Evaluation of community pharmacists' recommendations to standardize patient scenarios. Ann Pharmacother 2004;38:1080–5.

McCallian DJ, Cheigh NH. The pharmacist's role in self-care. J Am Pharm Assoc 2002;42(5 Suppl 1):40–1.

Shauna MB, Kirby J, Conrad WF. A structured approach for teaching students to counsel self-care. Patients Am J Pharm Educ 2007;71:1-7.

Saira A, Mohamed Azmi H, Mohamed Izham MI, Maqsood A, Imran M, Asrul AS. The role of pharmacists in developing countries: the current scenario in Pakistan. Hum Resour Health 2009;7:54.



How to Cite

Nordin, N., M. A. A. Hassali, and A. Sarriff. “STARZ-DRP AS A TRIAGING TOOL FOR COMMUNITY PHARMACISTS: PERSPECTIVES AND EXPECTATIONS OF STAKEHOLDERS”. International Journal of Pharmacy and Pharmaceutical Sciences, vol. 9, no. 10, Nov. 2017, pp. 81-86, doi:10.22159/ijpps.2017v9i11.20876.



Original Article(s)