Hughes Carmel M, McCann Siobhan
School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland.
Br J Gen Pract. 2003 Aug;53(493):600-6.
There have been calls for greater collaboration between general practitioners (GPs) and community pharmacists in primary care.
To explore barriers between the two professions in relation to closer interprofessional working and the extension of prescribing rights to pharmacists.
Qualitative study.
Three locality areas of a health and social services board in Northern Ireland.
GPs and community pharmacists participated in uniprofessional focus groups; data were analysed using interpretative phenomenology.
Twenty-two GPs (distributed over five focus groups) and 31 pharmacists (distributed over six focus groups) participated in the study. The 'shopkeeper' image of community pharmacy emerged as the superordinate theme, with subthemes of access, hierarchy and awareness. The shopkeeper image and conflict between business and health care permeated the GPs' discussions and accounted for their concerns regarding the extension of prescribing rights to community pharmacists and involvement inextended services. Community pharmacists felt such views influenced their position in the hierarchy of healthcare professionals. Although GPs had little problem in accessing pharmacists, they considered that patients experienced difficulties owing to the limited opening hours of pharmacies. Conversely, pharmacists reported great difficulty in accessing GPs, largely owing to the gatekeeper role of receptionists. GPs reported being unaware of the training and activities of community pharmacists and participating pharmacists also felt that GPs had no appreciation of their role in health care.
A number of important barriers between GPs and community pharmacists have been identified, which must be overcome if interprofessional liaison between the two professions is to be fully realised.
有人呼吁全科医生(GP)与社区药剂师在初级医疗保健中加强合作。
探讨这两个职业在更紧密的跨专业合作以及将处方权扩展至药剂师方面存在的障碍。
定性研究。
北爱尔兰一个卫生和社会服务委员会的三个地区。
全科医生和社区药剂师参与了各自专业的焦点小组讨论;数据采用解释性现象学进行分析。
22名全科医生(分布在5个焦点小组中)和31名药剂师(分布在6个焦点小组中)参与了该研究。社区药房的“店主”形象成为首要主题,还有获取、等级制度和认知等子主题。“店主”形象以及商业与医疗保健之间的冲突贯穿于全科医生的讨论中,并解释了他们对将处方权扩展至社区药剂师以及参与扩展服务的担忧。社区药剂师认为这种观点影响了他们在医疗保健专业人员等级制度中的地位。尽管全科医生联系药剂师没有太大问题,但他们认为由于药房营业时间有限,患者会遇到困难。相反,药剂师表示联系全科医生非常困难,主要原因是接待员的把关作用。全科医生表示不了解社区药剂师的培训和活动,参与研究的药剂师也觉得全科医生不理解他们在医疗保健中的作用。
已确定全科医生与社区药剂师之间存在一些重要障碍,如果要充分实现这两个职业之间的跨专业联络,就必须克服这些障碍。