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在社区药房推广体重管理服务:苏格兰药房团队的观点

Promoting weight management services in community pharmacy: perspectives of the pharmacy team in Scotland.

作者信息

Weidmann Anita Elaine, MacLure Katie, Marshall Sarah, Gray Gwen, Stewart Derek

机构信息

School of Pharmacy and Life Sciences, Robert Gordon University, Riverside East, Garthdee Road, Aberdeen, AB10 7GJ, UK,

出版信息

Int J Clin Pharm. 2015 Aug;37(4):599-606. doi: 10.1007/s11096-015-0102-7. Epub 2015 Mar 31.

Abstract

BACKGROUND

Obesity has reached pandemic levels with more than 1.4 billion adults affected worldwide. While there is a need to systematically develop and evaluate community pharmacy based models of weight management, it is imperative to describe and understand the perspectives of pharmacy staff. In the UK, trained and accredited community pharmacy medicines counter assistants (MCAs) are commonly the front line staff involved in patient consultations and sale of over-the-counter medicines.

OBJECTIVE

To explore the beliefs and experiences of pharmacists and MCAs in the North-East of Scotland on community pharmacy weight management.

SETTING

All 135 community pharmacies in the North-East of Scotland.

METHOD

A qualitative approach of semi-structured telephone interviews with 31 pharmacists and 20 MCAs in the North-East of Scotland. The semi-structured interview schedule was developed with reference to key domains describing professional practice (i.e. awareness and knowledge, skills, practicalities, motivation, acceptance and beliefs) and contextualised with policy documents and published research on community pharmacy based weight management. Interviews were audio-recorded, transcribed and analysed thematically.

MAIN OUTCOME MEASURE

Pharmacists' and MCAs' beliefs and experiences with delivering weight management services in community pharmacy.

RESULTS

There were mixed responses from pharmacists and MCAs around pharmacy based weight management services from positive views of providing the service in community pharmacy to those more reticent who would always favour patients visiting their physician. While all described similar services e.g. measurement of weight, healthy eating advice, supply of products, they acknowledged that support was often opportunistic at the request of customers, with little integration of other providers. Roles described varied from pharmacist only functions to any staff member. While pharmacists generally felt comfortable and confident, MCAs gave more diverse responses. Both Pharmacist and MCAs highlighted the need for a practice model which is systematically developed and suggested a scheme akin to the successful smoking cessation 12-week nicotine replacement therapy service already available in community pharmacies in Scotland.

CONCLUSION

Pharmacists and MCAs interviewed in this study reported their perceptions of benefits to providing community pharmacy based weight management as part of a wider public health function. They described services as opportunistic and customer driven based on ease of access. There was a notable variation in pharmacist and MCA training, reflected in their levels of comfort and confidence. There is a clear need to systematically develop and provide evidence of effectiveness and cost effectiveness for a pharmacy based practice model with key roles and functions for the full pharmacy team.

摘要

背景

肥胖已达到流行程度,全球有超过14亿成年人受其影响。虽然有必要系统地开发和评估基于社区药房的体重管理模式,但描述和了解药房工作人员的观点至关重要。在英国,经过培训并获得认证的社区药房药品柜台助理(MCAs)通常是参与患者咨询和非处方药销售的一线工作人员。

目的

探讨苏格兰东北部药剂师和药品柜台助理对社区药房体重管理的看法和经验。

地点

苏格兰东北部的所有135家社区药房。

方法

采用定性研究方法,对苏格兰东北部的31名药剂师和20名药品柜台助理进行半结构化电话访谈。半结构化访谈提纲是参照描述专业实践的关键领域(即意识和知识、技能、实际操作、动机、接受度和信念)制定的,并结合政策文件以及已发表的关于基于社区药房的体重管理的研究进行了情境化处理。访谈进行了录音、转录并进行主题分析。

主要观察指标

药剂师和药品柜台助理在社区药房提供体重管理服务的信念和经验。

结果

药剂师和药品柜台助理对基于药房的体重管理服务的反应不一,从对在社区药房提供该服务的积极看法到那些更沉默寡言、总是倾向于让患者去看医生的人的看法都有。虽然所有人都描述了类似的服务,如体重测量、健康饮食建议、产品供应,但他们承认,支持往往是应客户要求的机会性服务,很少与其他提供者整合。所描述的角色从仅由药剂师承担到任何工作人员都可承担不等。虽然药剂师总体上感觉自在和自信,但药品柜台助理的反应则更为多样。药剂师和药品柜台助理都强调需要一种系统开发的实践模式,并建议采用一种类似于苏格兰社区药房现有的成功的为期12周的戒烟尼古丁替代疗法服务的方案。

结论

本研究中接受访谈的药剂师和药品柜台助理报告了他们对将基于社区药房的体重管理作为更广泛公共卫生功能的一部分所带来益处的看法。他们将服务描述为基于便利性的机会性和客户驱动型服务。药剂师和药品柜台助理的培训存在显著差异,这反映在他们的自在程度和自信程度上。显然需要系统地开发并提供基于药房的实践模式的有效性和成本效益证据,该模式要明确药房团队全体人员的关键角色和职能。

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