Graduate Department of Pharmaceutical Sciences, University of Toronto, Toronto, Ontario M5S 3M2, Canada.
Res Social Adm Pharm. 2011 Mar;7(1):39-50. doi: 10.1016/j.sapharm.2010.02.005. Epub 2010 Apr 10.
Empirical evidence suggests that pharmacist-physician collaboration can improve patients' clinical outcomes; however, such collaboration occurs relatively infrequently in the community setting. There has been little research on physicians' perspectives of such collaboration.
To ascertain Ontario family physician readiness to collaborate with community pharmacists on drug therapy management.
The survey instrument was based on the transtheoretical model of behavior change. It enquired about 3 physician behaviors that represented low-, mid-, and high-level collaboration with pharmacists. The survey was distributed by fax or mail to a random sample of 848 Ontario family physicians and general practitioners, stratified by practice location (urban/rural).
The response rate was 36%. Most respondents reported conversing with community pharmacists about a patient's drug therapy management 5 or fewer times per week. Eighty-four percent reported that they regularly took community pharmacists' phone calls, whereas 78% reported that they sometimes sought pharmacists' recommendations regarding their patients' drug therapy. Twenty-eight percent reported that they sometimes referred their patients to community pharmacists for medication reviews, with 44% unaware of such a service. There were no differences in physician readiness to engage in any of the 3 collaborative behaviors in urban versus rural settings. More accurate patient medication lists were perceived as the main advantage (pro) of collaborating with community pharmacists and pharmacists' lack of patient information as the main disadvantage (con). Collectively, perceived pros of collaboration were positive predictors of physician readiness to collaborate on all 3 behaviors, whereas perceived cons were negative predictors for the low- and mid-level behaviors. Female physicians were more likely than males to seek pharmacists' recommendations, whereas more experienced physicians were more likely to refer patients to pharmacists for medication reviews.
Overall, Ontario physicians were more engaged in the low- and mid-level collaboration with community pharmacists with respect to drug therapy management. The strongest predictor of physician readiness to collaborate was perceived advantages of collaboration.
实证证据表明,药剂师与医师的合作可以改善患者的临床结局;然而,这种合作在社区环境中相对较少发生。关于医师对此类合作的看法的研究很少。
确定安大略省家庭医生准备与社区药剂师合作管理药物治疗的情况。
该调查工具基于行为改变的跨理论模型。它询问了代表与药剂师进行低、中、高水平合作的 3 种医生行为。该调查通过传真或邮件分发给安大略省 848 名家庭医生和全科医生的随机样本,按执业地点(城市/农村)进行分层。
回复率为 36%。大多数受访者报告说,每周与社区药剂师就患者的药物治疗管理进行 5 次或更少的交流。84%的人表示他们经常接听社区药剂师的电话,而 78%的人表示他们有时会征求药剂师对患者药物治疗的建议。28%的人表示他们有时会将患者转介给社区药剂师进行药物审查,而 44%的人不知道有这样的服务。在城市与农村环境中,医生准备从事任何 3 种合作行为方面没有差异。更准确的患者用药清单被认为是与社区药剂师合作的主要优势(赞成),而药剂师缺乏患者信息被认为是主要劣势(反对)。总的来说,合作的预期优势是医生准备在所有 3 种行为上进行合作的积极预测因素,而预期劣势是低水平和中水平行为的消极预测因素。女医生比男医生更有可能征求药剂师的建议,而经验丰富的医生更有可能将患者转介给药剂师进行药物审查。
总体而言,安大略省医生在药物治疗管理方面更倾向于与社区药剂师进行低水平和中水平的合作。医生准备合作的最强预测因素是合作的预期优势。