Zillich Alan J, McDonough Randal P, Carter Barry L, Doucette William R
Department of Pharmacy Practice, School of Pharmacy and Pharmacal Sciences, Purdue University, Indianapolis, IN 46202-2959, USA.
Ann Pharmacother. 2004 May;38(5):764-70. doi: 10.1345/aph.1D419. Epub 2004 Mar 18.
A theoretical model of physician/pharmacist collaborative relationships, driven by 3 groups of relationship characteristics termed participant, context, and exchange, has been developed. There are no studies that have examined the types of characteristics which most influence development of collaborative relationships between physicians and pharmacists.
To test the model and determine which drivers most influence physician/pharmacist collaboration.
Data on the relationship drivers and collaborative practice were collected via a mailed survey of a random sample of 1000 primary care physicians in Iowa. Participant variables include demographics; context drivers refer to the practice environment and professional interactions between physicians and pharmacists. Exchange characteristics describe the nature of social exchange and were elicited using scores from 3 domains (relationship initiation, trustworthiness, role specification) of the Physician/Pharmacist Collaboration Instrument (PPCI). Five additional questions asked about the physician's collaborative practice with a pharmacist. Hierarchical linear regression analysis was performed with collaborative practice as the dependent variable and measures of participant, context, and exchange drivers as independent variables.
Three hundred forty usable surveys (34%) were returned. Almost 70% of the respondents were male and aged 45.8 +/- 9.9 years (mean +/- SD). The majority were family practice physicians (72.1%) in private practice (67.3%). Regression analyses produced an R2 = 0.804 (p < 0.001). Significant predictors in the model were internal medicine physicians, professional interaction with a pharmacist, and the 3 domains of exchange drivers from the PPCI (p < 0.05).
Although participant and context factors influenced physician/pharmacist collaborative relationships, exchange characteristics were the most influential relationship drivers. Role specification, trustworthiness, and relationship initiation were positively associated with physician/pharmacist collaborative practice. Recognition of these drivers may help pharmacists who are developing collaborative working relationships with physicians. But, studies are needed to delineate other factors that may influence physician/pharmacist relationships.
已建立了一个由三组关系特征驱动的医生/药剂师合作关系理论模型,这三组特征分别称为参与者、背景和交换。尚无研究探讨最能影响医生与药剂师合作关系发展的特征类型。
检验该模型并确定哪些驱动因素对医生/药剂师合作影响最大。
通过对爱荷华州1000名初级保健医生的随机样本进行邮寄调查,收集有关关系驱动因素和合作实践的数据。参与者变量包括人口统计学特征;背景驱动因素指实践环境以及医生与药剂师之间的专业互动。交换特征描述社会交换的性质,并通过医生/药剂师合作工具(PPCI)的三个领域(关系建立、可信赖性、角色规范)的得分来得出。另外五个问题询问了医生与药剂师的合作实践情况。以合作实践作为因变量,以参与者、背景和交换驱动因素的测量值作为自变量进行分层线性回归分析。
共返回340份可用调查问卷(34%)。近70%的受访者为男性,年龄为45.8±9.9岁(均值±标准差)。大多数是从事私人执业的家庭医生(72.1%)(67.3%)。回归分析得出R2 = 0.804(p < 0.001)。模型中的显著预测因素为内科医生、与药剂师的专业互动以及PPCI中交换驱动因素的三个领域(p < 0.05)。
虽然参与者和背景因素会影响医生/药剂师合作关系,但交换特征是最具影响力的关系驱动因素。角色规范、可信赖性和关系建立与医生/药剂师合作实践呈正相关。认识到这些驱动因素可能有助于与医生建立合作工作关系的药剂师。但是,需要开展研究来阐明可能影响医生/药剂师关系的其他因素。