Williams Mackenzie, Peterson Gregory M, Tenni Peter C, Bindoff Ivan K
School of Pharmacy, University of Tasmania, Hobart, Tasmania, Australia.
Int J Pharm Pract. 2012 Aug;20(4):238-48. doi: 10.1111/j.2042-7174.2012.00188.x. Epub 2012 Feb 2.
Drug-related problems (DRPs) are associated with significant morbidity and mortality, with most DRPs thought to be preventable. Community pharmacists can detect and either prevent or resolve many of these DRPs. A survey-based clinical knowledge measurement tool was designed and validated to estimate a community pharmacist's clinical knowledge and ability to detect and appropriately resolve DRPs.
Nine clinical cases with seven multiple-choice statements (63 statements in total) were constructed, based on scenarios that were found to occur frequently in Australian community pharmacies. The statements aimed to assess a pharmacist's ability to identify, gather relevant information about and make appropriate recommendations to resolve, a DRP. The survey was pilot tested with 18 academics at three Australian pharmacy schools, resulting in the removal of 23 statements. The survey was then administered to undergraduate pharmacy students (28 fourth-year, 41 third-year and 42 first-year students) and to 433 Australian community pharmacists who were participating in an intervention documentation trial. The pharmacists' resultant survey scores were correlated against their actual rate of documenting clinical interventions.
The tool had relatively good internal consistency. Significant differences were seen between the three groups of students (P < 0.01). Community pharmacists with additional clinical qualifications had a significantly higher score than other participating pharmacists (P < 0.01). A moderate, but significant, correlation was seen between the pharmacists' survey score and their clinical intervention rate in practice during the trial (P < 0.01).
The clinical knowledge measurement tool appeared to estimate a pharmacist's ability to detect and resolve DRPs within the community pharmacy environment.
药物相关问题(DRPs)与显著的发病率和死亡率相关,大多数DRPs被认为是可预防的。社区药剂师能够发现并预防或解决其中许多问题。设计并验证了一种基于调查的临床知识测量工具,以评估社区药剂师的临床知识以及发现和妥善解决DRPs的能力。
根据在澳大利亚社区药房中经常出现的场景构建了9个临床病例,每个病例有7个多项选择题(共63个题目)。这些题目旨在评估药剂师识别、收集相关信息并提出适当建议以解决DRP的能力。该调查在澳大利亚三所药学院的18名学者中进行了预测试,结果删除了23个题目。然后对本科药学专业学生(28名四年级、41名三年级和42名一年级学生)以及433名参与干预记录试验的澳大利亚社区药剂师进行了调查。将药剂师的调查得分与其实际记录临床干预的比率进行相关性分析。
该工具具有相对较好的内部一致性。三组学生之间存在显著差异(P < 0.01)。具有额外临床资质的社区药剂师得分显著高于其他参与调查的药剂师(P < 0.01)。在试验期间,药剂师的调查得分与其实际临床干预率之间存在中等程度但显著的相关性(P < 0.01)。
该临床知识测量工具似乎能够评估药剂师在社区药房环境中发现和解决DRPs的能力。