Harris W. E., Rivers P. H., Goldstein R.
Community Pharmacy Advisor for the North and Southern Derbyshire Health Authority, Scarsdale, Chesterfield, Derbyshire; Medicines Research Unit, School of Health and Community Studies, University of Derby, Mickleover, Derby; Medicines Research Unit, School of Health and Community Studies, University of Derby, Derby, UK.
Health Soc Care Community. 1998 May;6(3):196-203. doi: 10.1046/j.1365-2524.1998.00121.x.
The traditional dispensing role of the community pharmacist is increasingly being questioned and greater emphasis is being placed on the provision of advice. Introduction of the NHS Community Care Act provides an opportunity to consider the potential role of community pharmacists in care management and in carrying out assessment of individual need. This paper describes the introduction of Community Care training for community pharmacists in Derbyshire and the results of a study to evaluate assessment and referrals that the community pharmacists routinely carried out. Fourteen pharmacists who participated in the study recorded assessments that they carried out over a 10-week period between January and April 1994. A total of 858 assessments were self-reported by the community pharmacists, of which 57% resulted from enquiries relating to physical symptoms, 27% relating to prescription medication and 8% from social problems. A further 7% arose from a combination of these categories. Nearly one third of all assessments were made at the request of a carer. Health care professionals had initiated 7% of the enquiries, with a greater proportion of these associated with prescription medication (46%) and social care (29%) compared with those initiated by patients (20% prescription medication, 6% social care) or carers (26% prescription medication, 6% social care). If a pharmacist intervened to initiate an enquiry, a greater proportion of assessments led to referral (33%) compared with 14-21% for other types of enquirer. This paper discusses the possibility of providing greater access to care-management, care planning and monitoring through making this process more widely available from community pharmacies on the high-street.
社区药剂师传统的配药角色正日益受到质疑，人们越来越重视提供建议。《国民健康服务社区护理法案》的出台为思考社区药剂师在护理管理和评估个体需求方面的潜在作用提供了契机。本文描述了德比郡为社区药剂师开展社区护理培训的情况，以及一项评估社区药剂师常规进行的评估和转诊情况的研究结果。参与该研究的14名药剂师记录了他们在1994年1月至4月的10周内所进行的评估。社区药剂师共自行报告了858次评估，其中57%源于对身体症状的询问，27%与处方药有关，8%来自社会问题。另有7%源于这些类别之间的组合。近三分之一的评估是应护理人员的要求进行的。医疗保健专业人员发起了7%的询问，与患者（20%为处方药，6%为社会护理）或护理人员（26%为处方药，6%为社会护理）发起的询问相比，这些询问中与处方药（46%）和社会护理（29%）相关的比例更高。如果药剂师进行干预发起询问，与其他类型询问者相比，更大比例的评估会导致转诊（33%），而其他类型询问者的转诊比例为14 - 21%。本文讨论了通过使这一过程在商业街的社区药房更广泛地开展，从而提供更多获得护理管理、护理计划和监测服务的可能性。
