Gidman Wendy, Ward Paul, McGregor Lesley
Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK.
BMJ Open. 2012 May 14;2(3). doi: 10.1136/bmjopen-2012-000939. Print 2012.
To apply sociological theories to understand public trust in extended services provided by community pharmacists relative to those provided by general practitioners (GPs).
Qualitative study involving focus groups with members of the public.
The West of Scotland.
26 purposively sampled members of the public were involved in one of five focus groups. The groups were composed to represent known groups of users and non-users of community pharmacy, namely mothers with young children, seniors and men.
Trust was seen as being crucial in healthcare settings. Focus group discussions revealed that participants were inclined to draw unfavourable comparisons between pharmacists and GPs. Importantly, participants' trust in GPs was greater than that in pharmacists. Participants considered pharmacists to be primarily involved in medicine supply, and awareness of the pharmacist's extended role was low. Participants were often reluctant to trust pharmacists to deliver unfamiliar services, particularly those perceived to be 'high risk'. Numerous system-based factors were identified, which reinforce patient trust and confidence in GPs, including GP registration and appointment systems, GPs' expert/gatekeeper role and practice environments. Our data indicate that the nature and context of public interactions with GPs fostered familiarity with a specific GP or practice, which allowed interpersonal trust to develop. By contrast, participants' exposure to community pharmacists was limited. Additionally, a good understanding of the GPs' level of training and role promoted confidence.
Current UK initiatives, which aim to implement a range of pharmacist-led services, are undermined by lack of public trust. It seems improbable that the public will trust pharmacists to deliver unfamiliar services, which are perceived to be 'high risk', unless health systems change in a way that promotes trust in pharmacists. This may be achieved by increasing the quality and quantity of patient interactions with pharmacists and gaining GP support for extended pharmacy services.
应用社会学理论来理解公众对社区药剂师提供的扩展服务相对于全科医生（GP）提供的服务的信任情况。
涉及公众焦点小组的定性研究。
苏格兰西部。
26名经过有目的抽样的公众参与了五个焦点小组中的一个。这些小组的组成代表了社区药房已知的用户和非用户群体，即有幼儿的母亲、老年人和男性。
信任在医疗环境中被视为至关重要。焦点小组讨论表明，参与者倾向于对药剂师和全科医生进行不利比较。重要的是，参与者对全科医生的信任大于对药剂师的信任。参与者认为药剂师主要参与药品供应，对药剂师扩展角色的认识较低。参与者通常不愿意信任药剂师提供不熟悉的服务，特别是那些被认为“高风险”的服务。确定了许多基于系统的因素，这些因素增强了患者对全科医生的信任和信心，包括全科医生注册和预约系统、全科医生的专家/把关人角色以及执业环境。我们的数据表明，公众与全科医生互动的性质和背景促进了对特定全科医生或诊所的熟悉，从而使人际信任得以发展。相比之下，参与者与社区药剂师的接触有限。此外，对全科医生培训水平和角色的良好理解增强了信心。
英国目前旨在实施一系列由药剂师主导的服务的举措因缺乏公众信任而受到破坏。除非卫生系统以促进对药剂师信任的方式进行变革，否则公众似乎不太可能信任药剂师提供被认为“高风险”的不熟悉服务。这可以通过增加患者与药剂师互动的质量和数量以及获得全科医生对扩展药房服务的支持来实现。
