Wibowo Yosi, Berbatis Constantine, Joyce Andrew, Sunderland V B
Curtin University of Technology, Perth, Western Australia, Australia.
Rural Remote Health. 2010 Jul-Sep;10(3):1400. Epub 2010 Aug 2.
Enhanced pharmacy services (EPS) are health related services above those normally available with the supply of medicines. Rural pharmacies could provide a diversity of EPS in response to the limited access and reduced health services available in rural areas. The objective of this study was to evaluate the provision of EPS in rural Western Australian (WA) pharmacies in 2006, compared with findings extracted from a national survey conducted in 2002. Barriers to and facilitators for the provision of ETS in rural settings were also analysed.
The survey was conducted in 2006, using a questionnaire developed from a 2002 Australian national survey questionnaire. The questionnaires were mailed to all 103 pharmacies in rural WA and 51 were returned (49.5%). Chi-squared tests were used to test associations between year of survey and provision of each EPS. Where significant associations were reported, logistic regression analyses that controlled for sex, age, PhARIA location (remoteness), and inclusion of a forward pharmacy area were performed.
The WA rural pharmacies offered a range of EPS. There were marked increases in weight testing and weight management services. The availability of smoking cessation services increased from 52% of rural pharmacies in 2002 to 63% in 2006. Other EPS (asthma, diabetes, hypertension, hyperlipidaemia), which correspond to the Australian Government National Health Priorities Areas were offered by 20% to 50% of pharmacies and had not increased between surveys. A continued shortage in the pharmacist workforce was a major barrier to EPS provision.
Provision of EPS in rural pharmacies is more important than in metropolitan pharmacies because there is often a lack of other sources for these services in rural and remote locations. A range of defined EPS were provided by 25% to 60% of rural and remote pharmacies, with other services offered in lower percentages. Significant increases were found in some important EPS, such as weight management. Additional support for EPS provision in rural and remote communities is required to increase uptake among pharmacists. Government and pharmacy bodies need to implement rural practice models to address identified pharmacist workforce barriers and improve access to EPS to rural communities.
强化药学服务（EPS）是指除药品供应通常提供的服务之外与健康相关的服务。农村药房可提供多种强化药学服务，以应对农村地区可及性有限和医疗服务减少的情况。本研究的目的是评估2006年西澳大利亚州（WA）农村药房的强化药学服务提供情况，并与2002年全国性调查的结果进行比较。同时还分析了农村地区提供强化药学服务的障碍和促进因素。
该调查于2006年进行，使用的问卷是在2002年澳大利亚全国调查问卷的基础上制定的。问卷被邮寄给西澳大利亚州农村地区的所有103家药房，共返回51份（49.5%）。采用卡方检验来检验调查年份与每项强化药学服务提供情况之间的关联。当报告有显著关联时，进行逻辑回归分析，对性别、年龄、偏远地区药房协会（PhARIA）位置（偏远程度）以及是否纳入前方药房区域进行控制。
西澳大利亚州农村药房提供了一系列强化药学服务。体重检测和体重管理服务有显著增加。戒烟服务的可及性从2002年农村药房的52%增加到2006年的63%。其他与澳大利亚政府国家卫生重点领域相对应的强化药学服务（哮喘、糖尿病、高血压、高脂血症）由20%至50%的药房提供，且在两次调查之间没有增加。药剂师劳动力持续短缺是提供强化药学服务的主要障碍。
农村药房提供强化药学服务比城市药房更为重要，因为在农村和偏远地区通常缺乏这些服务的其他来源。25%至60%的农村和偏远药房提供了一系列特定的强化药学服务，其他服务的提供比例较低。在一些重要的强化药学服务方面，如体重管理，有显著增加。需要为农村和偏远社区提供强化药学服务提供更多支持，以提高药剂师的参与度。政府和药房机构需要实施农村实践模式，以解决已确定的药剂师劳动力障碍，并改善农村社区获得强化药学服务的机会。
