Svensberg Karin, Sporrong Sofia Kälvemark, Björnsdottir Ingunn
School of Pharmacy, Section of Social Pharmacy, Research Group Pharma-Safe, University of Oslo, P.O. Box 1068, Blindern, 0316 Oslo, Norway.
Department of Pharmacy, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen, Denmark.
Res Social Adm Pharm. 2015 Nov-Dec;11(6):784-802. doi: 10.1016/j.sapharm.2015.01.002. Epub 2015 Jan 20.
Pharmacist-patient communication around prescription medications can optimize treatment outcomes. Society's expectations of pharmacist-patient communication around medications can be expressed in legislation, economic incentives, and authority control. In this study, the Nordic countries of Denmark, Finland, Iceland, Norway and Sweden provide the legislative examples and can be used as a platform to discuss how society's expectations, professional visions, and practice are aligning.
The overall aim of this study was to describe society's expectations of pharmacist-patient communication around medications as expressed by the state in Nordic legislation, economic incentives and authority control. Additionally, this study describes how the states govern Nordic pharmacists in different pharmacy systems.
A legal review was performed using online legislative databases. Regulating authorities were contacted to gather supplementary information. Thereafter, a qualitative document analysis was conducted.
The Nordic countries regulate staff-patient communication by using broad laws. The legislation's main focus during dispensing is information on the use of medications, but also generic substitution and pricing. Pharmacies should have internal routines for this in place. Pharmacists' obligation to keep a journal on advice given during dispensing is ambiguously regulated. The economic incentives for communication on prescription medication during dispensing are included in the general pharmacy mark-up. Today's authority control focuses on the pharmacy management and appears to primarily evaluate structure indicators of communication, for example, if there is a routine method of counseling available.
Various countries throughout the world differ in their requirements for pharmacy staff to communicate on the use of medicines during dispensing. The Nordic countries all require such communication, which aligns with professional visions. Regardless of the pharmacy system, the states let the employer and pharmacy professions carry out it in practice with apparently little state involvement, thus showing trust in the profession and employers. However, since Nordic communication studies show deviation from the legislation, there are reasons to reevaluate and discuss the legislation, the economic incentives and the control system.
围绕处方药进行的药师与患者沟通能够优化治疗效果。社会对药师与患者围绕药物进行沟通的期望可以通过立法、经济激励措施和权威控制来体现。在本研究中，丹麦、芬兰、冰岛、挪威和瑞典这几个北欧国家提供了立法方面的实例，可作为一个平台来讨论社会期望、专业愿景和实践是如何协调一致的。
本研究的总体目标是描述北欧立法、经济激励措施和权威控制所表达的社会对药师与患者围绕药物进行沟通的期望。此外，本研究还描述了各国在不同药房系统中对北欧药师的管理方式。
利用在线立法数据库进行法律审查。联系监管机构以收集补充信息。此后，进行了定性文件分析。
北欧国家通过宽泛的法律来规范员工与患者的沟通。配药过程中立法的主要重点是用药信息，但也包括通用名替换和定价。药房应该为此制定内部程序。对于药师在配药时提供建议记录日志的义务，相关规定并不明确。配药时就处方药进行沟通方面的经济激励措施包含在一般药房加价中。如今的权威控制侧重于药房管理，似乎主要评估沟通的结构指标；例如，是否存在常规咨询方法。
世界各国在要求药房工作人员在配药时就用药情况进行沟通方面存在差异。北欧国家都要求进行此类沟通，这与专业愿景相符。无论药房系统如何设置，各国在实际操作中都让雇主和药房行业自行开展，国家参与度明显较低，从而显示出对该行业和雇主的信任。然而，由于北欧的沟通研究表明存在与立法不符的情况，因此有理由重新评估和讨论立法、经济激励措施及控制系统。
