Tarn Derjung M, Paterniti Debora A, Wenger Neil S, Williams Bradley R, Chewning Betty A
Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles CA 900024, USA.
Int J Pharm Pract. 2012 Oct;20(5):285-93. doi: 10.1111/j.2042-7174.2012.00202.x. Epub 2012 Apr 11.
To investigate older patient, physician and pharmacist perspectives about the role of pharmacists in pharmacist-patient interactions.
Eight focus-group discussions were held in senior centres, community pharmacies and primary care physician offices. Participants were 42 patients aged 63 years and older, 17 primary care physicians and 13 community pharmacists. Qualitative analysis of the focus-group discussions was performed.
Participants in all focus groups indicated that pharmacists are a good resource for basic information about medications. Physicians appreciated pharmacists' ability to identify drug interactions, yet did not comment on other specific aspects related to patient education and care. Physicians noted that pharmacists often were hindered by time constraints that impeded patient counselling. Both patient and pharmacist participants indicated that patients often asked pharmacists to expand upon, reinforce and explain physician-patient conversations about medications, as well as to evaluate medication appropriateness and physician treatment plans. These groups also noted that patients confided in pharmacists about medication-related problems before contacting physicians. Pharmacists identified several barriers to patient counselling, including lack of knowledge about medication indications and physician treatment plans.
Community-based pharmacists may often be presented with opportunities to address questions that can affect patient medication use. Older patients, physicians and pharmacists all value greater pharmacist participation in patient care. Suboptimal information flow between physicians and pharmacists may hinder pharmacist interactions with patients and detract from patient medication management. Interventions to integrate pharmacists into the patient healthcare team could improve patient medication management.
探讨老年患者、医生和药剂师对药剂师在医患互动中作用的看法。
在老年中心、社区药房和初级保健医生办公室举行了八次焦点小组讨论。参与者包括42名63岁及以上的患者、17名初级保健医生和13名社区药剂师。对焦点小组讨论进行了定性分析。
所有焦点小组的参与者均表示，药剂师是获取药物基本信息的良好资源。医生赞赏药剂师识别药物相互作用的能力，但未对与患者教育和护理相关的其他具体方面发表评论。医生指出，药剂师经常受到时间限制的阻碍，这妨碍了对患者的咨询。患者和药剂师参与者均表示，患者经常要求药剂师详细阐述、强化并解释医患之间关于药物的对话，以及评估药物的适当性和医生的治疗计划。这些小组还指出，患者在联系医生之前会向药剂师倾诉与药物相关的问题。药剂师确定了患者咨询的几个障碍，包括对药物适应症和医生治疗计划缺乏了解。
社区药剂师可能经常有机会解决影响患者用药的问题。老年患者、医生和药剂师都重视药剂师更多地参与患者护理。医生和药剂师之间信息流通不畅可能会妨碍药剂师与患者的互动，并影响患者的药物管理。将药剂师纳入患者医疗团队的干预措施可以改善患者的药物管理。
