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全科医生对家庭药物评估的看法:一项定性分析。

General practitioners' perceptions on home medicines reviews: a qualitative analysis.

作者信息

Dhillon Amrith Kaur, Hattingh Hendrika Laetitia, Stafford Andrew, Hoti Kreshnik

机构信息

School of Pharmacy, Curtin University, Bentley, Perth, 6845, Australia.

出版信息

BMC Fam Pract. 2015 Feb 7;16:16. doi: 10.1186/s12875-015-0227-8.

Abstract

BACKGROUND

Home Medicines Review (HMR) is an Australian initiative introduced in 2001 to improve quality use of medicines. Medication management services such as HMRs have the potential to reduce medication related problems. In 2011, changes to the HMR program were introduced to allow for referrals directly to accredited pharmacists in addition to the community pharmacy referral model. These changes were introduced to improve efficiency of the process. This study explored the perceptions of Western Australian general practitioners (GPs) on benefits and barriers of the HMR service and process, including their insights into the direct referral model.

METHODS

Purposive sampling of GPs who had experience ensured that participants had a working knowledge of the HMR service. Semi structured interviews with 24 GPs from 14 metropolitan Western Australian medical centres between March and May 2013. Transcribing and thematic analysis of data were performed.

RESULTS

Most GPs had positive attitudes towards the HMR service. Main perceived benefits of the service were poly-pharmacy reduction and education for both the GP and patient. Strategies identified to improve the service were introduction of a standard HMR report template for pharmacists and better use of technology. Whilst reliability and GPs' familiarity were the main perceived benefits of the direct referral model, a number of GPs agreed that patient unfamiliarity with the HMR pharmacist was a barrier.

CONCLUSIONS

Despite recognition of the value of the HMR service participating GPs were of the opinion that there are aspects of the HMR service that could be improved. As one of the success factors of HMRs is relying on GPs to utilise this service, this study provides valuable insight into issues that need to be addressed to improve HMR uptake.

摘要

背景

家庭药物审查(HMR)是澳大利亚于2001年推出的一项举措,旨在改善药物的合理使用。诸如HMR之类的药物管理服务有潜力减少与药物相关的问题。2011年,对HMR计划进行了调整,除社区药房转诊模式外,还允许直接转诊至经认可的药剂师。引入这些变化是为了提高流程效率。本研究探讨了西澳大利亚州全科医生(GP)对HMR服务及流程的益处和障碍的看法,包括他们对直接转诊模式的见解。

方法

对有经验的全科医生进行目的抽样,以确保参与者对HMR服务有实际了解。2013年3月至5月期间,对来自西澳大利亚州14个大都市医疗中心的24名全科医生进行了半结构化访谈。对数据进行了转录和主题分析。

结果

大多数全科医生对HMR服务持积极态度。该服务主要的可感知益处是减少多重用药以及对全科医生和患者的教育。确定的改善该服务的策略包括为药剂师引入标准的HMR报告模板以及更好地利用技术。虽然可靠性和全科医生的熟悉度是直接转诊模式主要的可感知益处,但一些全科医生一致认为患者对HMR药剂师不熟悉是一个障碍。

结论

尽管认识到HMR服务的价值,但参与的全科医生认为HMR服务的某些方面仍可改进。由于HMR的成功因素之一是依靠全科医生使用该服务,本研究为改善HMR的接受度需要解决的问题提供了有价值的见解。

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