Roberts Alison S, Benrimoj S I Charlie, Chen Timothy F, Williams Kylie A, Hopp Trine R, Aslani Parisa
Pharmacy Practice Research, Faculty of Pharmacy, University of Sydney, NSW 2006, Australia.
Res Social Adm Pharm. 2005 Dec;1(4):546-64. doi: 10.1016/j.sapharm.2005.09.003.
Much of the research on cognitive pharmaceutical services has focused on understanding or changing community pharmacist behaviour, with few studies focusing on the pharmacy as the unit of analysis or considering the whole profession as an organisation.
To investigate practice change and identify facilitators of this process in community pharmacy, with specific focus on the implementation of cognitive pharmaceutical services (CPS) and related programs.
Thirty-six in-depth, semistructured interviews were conducted with participants from 2 groups, community pharmacies and pharmacy "strategists," in Australia. The interview guide was based on a framework of organizational theory, with 5 subject areas: roles and goals of participants in relation to practice change; experiences with CPS; change strategies used; networks important to the change process; and business impacts of CPS. Interviews were transcribed verbatim and thematically content analyzed, using NVivo software for data management.
Five key themes relating to the change process were derived from the interviews: change strategies (process- and behaviorally oriented); social networks (within and beyond the pharmacy); drivers of change (eg, government policy); motivators (eg, professional satisfaction); and facilitators of practice change (remuneration for implementation or service delivery, communication and teamwork, leadership, task delegation, external support or assistance, and reorganization of structure and function).
The use of an organizational perspective yielded rich data from which an understanding of the practice change process in relation to CPS implementation was gained. Current programs for the implementation and delivery of CPS have not taken into account all of the factors that have the ability to facilitate change in community pharmacy. Not only do future programs need to be underpinned by these elements, but policy makers must include them when planning remuneration and dissemination strategies.
认知药学服务的大部分研究都集中在理解或改变社区药剂师的行为上，很少有研究将药房作为分析单位或把整个行业视为一个组织来考虑。
调查社区药房的实践变化并确定这一过程的促进因素，特别关注认知药学服务（CPS）及相关项目的实施。
对来自澳大利亚的两组参与者进行了36次深入的半结构化访谈，这两组参与者分别是社区药房和药房“战略家”。访谈指南基于组织理论框架，有5个主题领域：参与者在实践变革方面的角色和目标；CPS的经验；使用的变革策略；对变革过程重要的网络；以及CPS的商业影响。访谈逐字记录，并进行主题内容分析，使用NVivo软件进行数据管理。
从访谈中得出了与变革过程相关的五个关键主题：变革策略（以过程和行为为导向）；社交网络（药房内部和外部）；变革驱动因素（如政府政策）；激励因素（如职业满意度）；以及实践变革的促进因素（实施或服务提供的薪酬、沟通与团队合作、领导力、任务分配、外部支持或援助，以及结构和功能的重组）。
采用组织视角产生了丰富的数据，从中获得了对与CPS实施相关的实践变革过程的理解。当前CPS实施和提供的项目没有考虑到所有能够促进社区药房变革的因素。未来的项目不仅需要以这些要素为基础，而且政策制定者在规划薪酬和推广策略时必须纳入这些要素。
