Bajorek Beata, LeMay Kate, Gunn Kate, Armour Carol
Graduate School of Health (Pharmacy), University of Technology Sydney, Ultimo, NSW, Australia.
The Woolcock Institute of Medical Research, Glebe, NSW, Australia.
Australas Med J. 2015 Feb 28;8(2):52-63. doi: 10.4066/AMJ.2015.2278. eCollection 2015.
The Australian government's General Practitioner (GP) super clinics programme aims to provide well-integrated, multidisciplinary, patient-centred care for people with chronic disease. However, there is no research into the current role of pharmacists in this setting.
To explore the perspectives of GP super clinic staff on current and potential (future) pharmacist-led services provided in this setting.
Individual interviews (facilitated using a semi-structured interview guide and thematically analysed) were conducted with purposively sampled staff of a GP super clinic in a semirural location in the state of New South Wales, until theme saturation. Participating staff included (n=9): three GPs, one pharmacist, one nurse, one business manager, and three reception staff.
Three themes emerged conveying perspectives on: working relationships between staff; a pharmacist's current role; and potential future roles for a pharmacist. All clinic staff actively engaged the pharmacist in their "team approach". Currently established roles for home medicines reviews (HMRs) and drug information were well supported, but needed to be expanded, for example, with formalised case conferences between GPs, pharmacists, and other staff. New roles needed be explored in auditing medication use, optimising medication records, specialised drug information, dispensing, and prescribing. Although GPs had differing views about opportunities for pharmacists' prescribing in this setting, they saw several benefits to this service, such as reducing the time pressure on GPs to enable more effective consultations.
Results suggest a pharmacist's services can potentially be better used within the multidisciplinary super clinic model of care to address current gaps within the semi-rural practice setting. Any future role for the pharmacist could be addressed as part of a formalised, strategic approach to creating an integrated healthcare team, with attention to funding and government legislation.
澳大利亚政府的全科医生（GP）超级诊所项目旨在为慢性病患者提供全面整合、多学科、以患者为中心的护理。然而，目前尚无关于药剂师在此环境中当前作用的研究。
探讨全科医生超级诊所工作人员对在此环境中当前及潜在（未来）由药剂师主导的服务的看法。
对新南威尔士州一个半农村地区的全科医生超级诊所的目标抽样工作人员进行个人访谈（使用半结构化访谈指南进行引导并进行主题分析），直至主题饱和。参与访谈的工作人员包括（n = 9）：三名全科医生、一名药剂师、一名护士、一名业务经理和三名接待人员。
出现了三个主题，传达了对以下方面的看法：工作人员之间的工作关系；药剂师的当前角色；以及药剂师未来的潜在角色。所有诊所工作人员都积极让药剂师参与他们的“团队方法”。目前确定的家庭药物审查（HMRs）和药物信息角色得到了很好的支持，但需要扩大，例如，通过全科医生、药剂师和其他工作人员之间的正式病例讨论会。需要探索在审核用药、优化用药记录、专业药物信息、配药和开处方方面的新角色。尽管全科医生对药剂师在此环境中开处方的机会有不同看法，但他们看到了这项服务的几个好处，比如减轻全科医生的时间压力，以便进行更有效的咨询。
结果表明，在多学科超级诊所护理模式中，药剂师的服务可能会得到更好的利用，以弥补半农村实践环境中的当前差距。药剂师未来的任何角色都可以作为创建综合医疗团队的正式战略方法的一部分来解决，同时要关注资金和政府立法。
