The prevalence and impact of workplace violence in community pharmacies: a mixed-methods study

TL;DR

This study finds that workplace violence is common in community pharmacies, especially affecting pharmacy technicians, and suggests measures to improve safety and mental well-being.

Contribution

The study provides new insights into the prevalence and psychological impact of workplace violence in community pharmacies using mixed methods.

Findings

63.2% of participants reported experiencing at least one violent incident, with verbal violence being the most common form.

Pharmacy technicians reported higher exposure to violence and higher anxiety scores compared to pharmacists.

Participants often refrained from legal action due to burnout and normalization of violence in their profession.

Abstract

Pharmacists and pharmacy technicians employed in community pharmacies face a considerable risk of workplace violence, which can negatively influence their job satisfaction, productivity, and mental well-being. This study examined the prevalence and consequences of workplace violence in community pharmacies in Ankara through a mixed-methods design integrating cross-sectional survey data with qualitative insights.

The target population included pharmacists and pharmacy technicians. We examined demographic factors, psychological outcomes, and the nature of violent incidents. Data were obtained from a random sample of 355 community pharmacies using a 39-item survey and the depression anxiety stress scales (DASS-21), complemented by qualitative interviews with 12 pharmacists.

A total of 242 participants took part in the study: 174 pharmacists (71.9%; median age 46.0 years) and 68 pharmacy technicians (28.1%; median age 35.0 years). Overall, 63.2% reported at least one violent incident (58.0% of pharmacists; 76.5% of pharmacy technicians). Verbal violence emerged as the most prevalent form, with pharmacy technicians reporting significantly higher exposure than pharmacists. Perpetrators were most often patients or their relatives, while broader societal violence and deficiencies within the health system were frequently cited as contributing factors. Many participants refrained from taking legal action, attributing this to professional burnout and the perception of violence as an inherent aspect of their occupation. Findings from the DASS-21 revealed higher anxiety scores among pharmacy technicians compared to pharmacists. Among pharmacists, exposure to workplace violence was paradoxically associated with lower stress and depression scores, a pattern not observed among technicians.

Workplace violence in community pharmacies is prevalent—particularly verbal abuse—and disproportionately impacts pharmacy technicians. Addressing this issue necessitates enhanced training, institutional support, and strengthened security measures, alongside extending white code legal protections to community pharmacies to improve safety and service quality.