Bryant Linda, Coster Gregor, McCormick Ross
Department of General Practice and Primary Health Care, The University of Auckland, PB 92019 Auckland, New Zealand.
J Prim Health Care. 2010 Sep 1;2(3):234-42.
Changes in delivery of health care services has led to pressure for community pharmacists to extend their traditional role and become more involved with patient-focussed services such as medication reviews, in collaboration with general practitioners (GPs). This has not been generally implemented into routine practice, and many barriers have been suggested that inhibit community pharmacists extending their role. These have often focussed on physical or functional barriers. This study explores possible attitudinal factors that prevent increased participation of community pharmacists in medication reviews undertaken in collaboration with GPs.
Twenty community pharmacist participants who participated in the General Practitioner-Pharmacist Collaboration (GPPC) study were interviewed. The GPPC study investigated the outcomes of community pharmacists undertaking a clinical medication review in collaboration with GPs, and the potential barriers. Semi-structured interviews were analysed using a general inductive thematic approach.
Emerging themes were that community pharmacists perceived that they were not mandated to undertake this role, it was not a legitimate role, particularly from the business perceptive, and pharmacists were concerned that they lacked the skills and confidence to provide this level of input.
While there is concern that community pharmacists' skills are underutilised, there are probable attitudinal barriers inhibiting pharmacists from increasing their role in clinical medication reviews. Perceived legitimacy of the service was a dominant theme, which appeared to be related to issues in the business model. Further investigation should consider the use of a clinical pharmacist working within a general practice independent of a community pharmacy.
医疗保健服务提供方式的变化给社区药剂师带来了压力,促使他们拓展传统角色,并与全科医生(GP)合作,更多地参与以患者为中心的服务,如药物审查。然而,这一举措尚未普遍纳入日常实践,人们提出了许多阻碍社区药剂师拓展角色的因素,这些因素往往集中在物理或功能障碍方面。本研究探讨了可能阻碍社区药剂师更多参与与全科医生合作进行药物审查的态度因素。
对参与全科医生 - 药剂师合作(GPPC)研究的20名社区药剂师参与者进行了访谈。GPPC研究调查了社区药剂师与全科医生合作进行临床药物审查的结果以及潜在障碍。采用一般归纳主题法对半结构化访谈进行了分析。
新出现的主题是,社区药剂师认为他们没有被授权承担这一角色,这不是一个合法的角色,特别是从商业角度来看,药剂师担心他们缺乏提供这种程度投入所需的技能和信心。
虽然人们担心社区药剂师的技能未得到充分利用,但可能存在态度障碍阻碍药剂师在临床药物审查中发挥更大作用。服务的感知合法性是一个主要主题,这似乎与商业模式中的问题有关。进一步的调查应考虑使用独立于社区药房在全科医疗中工作的临床药剂师。