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BackgroundCommunity pharmacies are one of the first contact points for essential health care in Nepal particularly for those living in cities with limited access to primary care. With increasing prevalence of non-communicable diseases there is increasing recognition that pharmacies should be competent and well-equipped to provide basic services for clients with common NCDs. This paper aims to assess the hypertension and diabetes services delivered by pharmacies and their readiness to deliver quality services in Pokhara Metropolitan City (PMC).MethodsWe identified all pharmacies providing hypertension and diabetes services in the 33 wards of PMC and gained their consent to complete an adapted version of World Health Organization’s Service Availability and Readiness Assessment (SARA) and National Health Facility Survey 2015. The adapted tool assessed the characteristics, extent and quality of diabetes and hypertension services provided within the pharmacies. Readiness to deliver hypertension services was assessed across two domains: i) trained human resource and guidelines and ii) available drugs and supplies; with the addition domain of iii) diagnostics for diabetes. Data analysis was conducted using R studio (version 4.3.0).ResultsA total of 352 private pharmacies were identified in PMC, 94% of which were registered. The main provider of services was a pharmacist with a paramedic background (37%). While all pharmacies were providing provisional, definitive diagnosis and treatment for diabetes and hypertension, few were categorized as ‘ready’ to deliver appropriate and quality diabetes or hypertension services, with a mean readiness score of 30.7 for diabetes and 32.1 for hypertension. The average score was highest for the essential equipment and supplies domain for diabetes whereas for hypertension services it was comparatively lower. There were no statistically significant differences in service readiness for both diabetes and hypertension between pharmacies with and without paramedics.ConclusionIn urban areas, private pharmacies are involved in the management of non-communicable diseases particularly diabetes and hypertension, but they are poorly resourced, with little guidance and training. Given the continued lack of sufficient public primary care services to meet the needs of the growing urban population, comprehensive training to enhance the capacity of pharmacy staff in the management of diabetes and hypertension, aligning with WHO’s Package of Essential NCD (PEN) guidelines is needed. Standardized clinical protocols, strengthened regulatory oversight through registration, licensing and continuous monitoring will further support quality service provision.背景 社区药房是尼泊尔基本医疗服务的首要接触点之一，尤其针对那些生活在难以获取初级医疗服务城市的人群。随着非传染性疾病（non-communicable diseases, NCDs）患病率持续攀升，社会各界日益认识到，药房应具备充足能力与完善配置，为罹患常见非传染性疾病的患者提供基础医疗服务。本研究旨在评估博克拉都会市（Pokhara Metropolitan City, PMC）内药房提供的高血压与糖尿病诊疗服务，及其开展高质量服务的准备情况。 方法 我们排查了博克拉都会市下辖33个社区中所有提供高血压与糖尿病诊疗服务的药房，并征得其同意，采用改编版世界卫生组织（World Health Organization, WHO）《服务可及性与准备度评估（Service Availability and Readiness Assessment, SARA）》及《2015年国家卫生设施调查》工具开展调研。改编后的评估工具用于测评药房内提供的糖尿病与高血压诊疗服务的特征、覆盖范围与服务质量。高血压服务开展准备度从两大维度进行测评：① 经过培训的人力资源与诊疗指南；② 可用药品与物资；糖尿病服务准备度则额外增设了③ 诊断检测这一维度。数据分析采用RStudio（版本4.3.0）完成。 结果 本次调研共在博克拉都会市排查出352家私人药房，其中94%已完成注册。主要服务提供者为具备辅助医疗背景的药剂师，占比37%。尽管所有药房均能为糖尿病与高血压患者提供临时性及确定性诊断与治疗服务，但仅有极少数药房被归类为“具备开展规范高质量糖尿病/高血压诊疗服务的准备度”，糖尿病服务的平均准备度得分为30.7，高血压服务为32.1。糖尿病服务维度中，基本设备与物资分项的平均得分最高；而高血压服务的该分项得分则相对偏低。有无辅助医疗背景人员的药房，在糖尿病与高血压服务的准备度方面均无统计学意义上的显著差异。 结论 在城市地区，私人药房参与了非传染性疾病尤其是糖尿病与高血压的管理工作，但这类药房资源匮乏，且缺乏相应的指导与培训。鉴于当前仍缺乏足够的公共初级医疗服务以满足日益增长的城市人口需求，因此需要开展综合培训，以提升药房工作人员的糖尿病与高血压管理能力，并使其符合世界卫生组织《非传染性疾病基本服务包（Package of Essential NCD, PEN）》指南要求。标准化临床规程、通过注册与许可强化监管监督及持续监测，将进一步助力高质量诊疗服务的开展。