Mandt Ingunn, Horn Anne Marie, Granås Anne Gerd
Apoforsk - Institutt for apotekforskning, Postboks 5070 Majorstuen, 0301 Oslo, Norway.
Tidsskr Nor Laegeforen. 2009 Sep 24;129(18):1846-9. doi: 10.4045/tidsskr.08.0393.
Pharmacists intervene on about 2 % of prescriptions dispensed in Norwegian community pharmacies. The aim of this study was to explore how general practitioners (GPs) and community pharmacists communicate and document prescription interventions, and to discuss what both professions consider to be best practice.
Five GPs, five community pharmacists and two medical secretaries were recruited, from two regions in Norway, to form two focus groups. The groups were invited to discuss 12 real examples of prescription interventions (from a former study of pharmacy practice) from six intervention categories. Statements from the focus groups were analyzed and recurrent themes identified.
The GPs and pharmacists described varying management of the pharmacists' prescription interventions. Both expected the other profession to file these interventions and would only file a selection themselves. Correction of prescription interventions was not a well-established functionality of the GPs' electronic medical record systems. Lack of guidelines caused individual variations in both GP and pharmacist handling of such interventions. In general, the pharmacists prioritized to contact GPs for the clinically relevant interventions. GPs wanted more feedback than that provided by the pharmacists.
Joint guidelines for use in pharmacies and GP surgeries, are needed on communication, documentation, and priorities of prescription interventions. IT-software should be developed to facilitate real-time communication between the parties.
在挪威社区药房配药的处方中，药剂师干预约2%。本研究的目的是探讨全科医生（GP）和社区药剂师如何就处方干预进行沟通和记录，并讨论这两个职业都认为的最佳实践。
从挪威的两个地区招募了五名全科医生、五名社区药剂师和两名医疗秘书，组成两个焦点小组。邀请这些小组讨论来自六个干预类别的12个处方干预实际例子（来自以前的药房实践研究）。对焦点小组的陈述进行分析并确定反复出现的主题。
全科医生和药剂师描述了药剂师处方干预的不同管理方式。双方都期望对方记录这些干预措施，自己只记录一部分。处方干预的修正并非全科医生电子病历系统的既定功能。缺乏指导方针导致全科医生和药剂师在处理此类干预措施时存在个体差异。一般来说，药剂师优先就临床相关干预措施联系全科医生。全科医生希望得到比药剂师提供的更多反馈。
需要制定关于药房和全科医生诊所中处方干预的沟通、记录和优先级的联合指导方针。应开发信息技术软件以促进双方之间的实时沟通。
