George Johnson, Pfleger David, McCaig Dorothy, Bond Christine, Stewart Derek
School of Pharmacy, The Robert Gordon University, Schoolhill, Aberdeen, Scotland, AB10 1FR, UK.
Pharm World Sci. 2006 Apr;28(2):45-53. doi: 10.1007/s11096-006-9018-6. Epub 2006 Jun 4.
To investigate community pharmacists' awareness, views and attitudes relating to independent prescribing by community pharmacists and their perceptions of competence and training needs for the management of some common conditions.
Community pharmacies in Scotland.
A pre-piloted postal questionnaire was mailed to 500 randomly selected community pharmacies in Scotland for completion by the 'main pharmacist'.
Scottish community pharmacists' awareness, views and attitudes towards independent prescribing by community pharmacists; perceived competence and training needs in relation to diagnosis and treatment of conditions in four therapeutic areas; perceptions about patient accessibility to medicines and safety of independent prescribing by community pharmacists; and attitudes towards becoming an independent prescriber. The items regarding perceptions and attitudes were subjected to Principal Components Analysis (PCA) to identify the domains. Univariate analysis was performed on individual items in the questionnaire against total scores on the identified domains; significant variables in univariate analysis were further analysed in linear regression models.
A response rate of 43.4% (217/500) was achieved. Despite expressing confidence in their abilities to become independent prescribers and feeling competent in diagnosing and treating those conditions listed in the questionnaire, clinical training prior to implementation of independent prescribing was regarded important by 211 (97.7%) respondents, while 191 (88.4%) regarded clinical training in drugs used for treating the conditions to be important. Gaining improved patient consultation skills and ability to communicate prescribing actions to GP practices were regarded to be important by 125 (57.9%) and 172 (80.0%), respectively. In PCA, three domains--confidence in independent prescribing, satisfaction with the current methods of supply, and requirements for the process of independent prescribing were identified. Practising more hours per week as a pharmacist (p = 0.01), supplementary prescribing training (p = 0.02), and involvement in Scottish Executive pharmaceutical care model schemes (p = 0.02), were found to be associated with greater 'confidence in independent prescribing'.
High awareness of independent prescribing and perceived competence in diagnosing and selecting appropriate drugs for treating many common conditions were identified. Prescribing training with emphasis on evidence-based medicine, generic issues of prescribing and diagnostic and consultation skills is warranted before independent prescribing is undertaken by community pharmacists.
调查社区药剂师对社区药剂师独立处方的认识、看法和态度，以及他们对管理一些常见病症的能力和培训需求的认知。
苏格兰的社区药房。
向苏格兰随机抽取的500家社区药房邮寄一份预先试点的邮政问卷，由“主要药剂师”填写。
苏格兰社区药剂师对社区药剂师独立处方的认识、看法和态度；在四个治疗领域中与病症诊断和治疗相关的感知能力和培训需求；对患者获取药品的看法以及社区药剂师独立处方的安全性；以及对成为独立处方者的态度。对有关认知和态度的项目进行主成分分析（PCA）以确定领域。针对问卷中的各个项目与所确定领域的总分进行单变量分析；单变量分析中的显著变量在线性回归模型中进一步分析。
回复率为43.4%（217/500）。尽管对自己成为独立处方者的能力表示有信心，并且对诊断和治疗问卷中列出的病症感到有能力，但211名（97.7%）受访者认为在实施独立处方之前进行临床培训很重要，而191名（88.4%）受访者认为对用于治疗这些病症的药物进行临床培训很重要。分别有125名（占57.9%）和172名（占80.0%）受访者认为提高患者咨询技能以及向全科医生诊所传达处方行为的能力很重要。在主成分分析中，确定了三个领域——对独立处方的信心、对当前供应方法的满意度以及对独立处方过程的要求。发现每周作为药剂师工作时间更长（p = 0.01）、接受补充处方培训（p = 0.02）以及参与苏格兰行政部门的药学护理模式计划（p = .02）与更高的“对独立处方的信心”相关。
发现社区药剂师对独立处方的认识较高，并且在诊断和选择治疗多种常见病症的合适药物方面有一定的感知能力。在社区药剂师进行独立处方之前，有必要进行以循证医学、处方的一般问题以及诊断和咨询技能为重点的处方培训。
