Loewen Peter, Merrett Faye, Lemos Jane DE
Faculty of Pharmaceutcial Sciences, University of British Columbia , and Regional Pharmacy Coordinator - Education & Research, VCHPHC Regional Pharmacy Services. Vancouver ( Canada ).
Clinical pharmacist, Vancouver General Hospital. Vancouver ( Canada ).
Pharm Pract (Granada). 2010 Apr;8(2):89-95. doi: 10.4321/s1886-36552010000200002. Epub 2010 Mar 15.
Limitations on health care resources necessitate careful focus on activities that lead to the greatest improvement in patient outcomes. Despite the importance of aligning pharmacists' time with activities deriving the most impact, there is a paucity of literature on the correlations between pharmacists' perceptions of the impact of their activities, how they actually spend their time and how these align with published evidence of impacts on patient outcomes.
To reveal hospital pharmacists' perceptions of the impacts of their clinical activities and to characterize the correlation between the activities performed and both their perceptions of and the published evidence for their impacts on patient care.
Observational qualitative interviews and quantitative questionnaires were conducted with each participant (N=21) to characterize their work day and determine their perceptions of the impact of their activities. A systematic literature review catalogued pharmacists' activities with impact on patient outcomes. Primary endpoint: degree of correlation in three pair-wise comparisons between pharmacists' perceptions of impact, time allotted to activities, and published evidence of impact.
Pharmacists' time spent was positively and significantly correlated with their perception of impact (P=0.037) but not with the published evidence of impact (in either of the two analytical scenarios). The correlation between published evidence and pharmacists' perceptions of impacts was on the threshold of statistical significance with a moderate strength of association in one of the two analytical scenarios used.
Pharmacists dedicate more of their clinical time to activities they perceive to have greater impact. However, these perceptions and their time allocation does not correlate well with published evidence, and some misperceptions about impacts deserve correction. More rigorous research is needed to quantify the value of pharmacist services to the health care system, however designing such studies to isolate the value of specific activities will be challenging.
医疗保健资源的限制使得有必要仔细关注那些能给患者治疗结果带来最大改善的活动。尽管让药剂师的时间与最具影响力的活动保持一致很重要,但关于药剂师对其活动影响的认知、他们实际的时间分配方式以及这些与已发表的对患者治疗结果影响的证据之间的相关性,相关文献却很匮乏。
揭示医院药剂师对其临床活动影响的认知,并描述所开展活动与其对患者护理影响的认知以及已发表证据之间的相关性。
对每位参与者(N = 21)进行观察性定性访谈和定量问卷调查,以描述他们的工作日并确定他们对活动影响的认知。系统的文献综述梳理了对患者治疗结果有影响的药剂师活动。主要终点:药剂师对影响的认知、分配给活动的时间以及已发表的影响证据这三者在三对两两比较中的相关程度。
药剂师花费的时间与他们对影响的认知呈显著正相关(P = 0.037),但与已发表的影响证据无关(在两种分析情形中的任何一种中均如此)。在两种分析情形之一中,已发表证据与药剂师对影响的认知之间的相关性处于统计学显著性阈值,关联强度中等。
药剂师将更多的临床时间投入到他们认为影响更大的活动中。然而,这些认知及其时间分配与已发表证据的相关性不佳,一些对影响的误解值得纠正。需要更严谨的研究来量化药剂师服务对医疗保健系统的价值,然而设计此类研究以分离特定活动的价值将具有挑战性。