Bajorek Beata V, Lemay Kate S, Magin Parker J, Roberts Christopher, Krass Ines, Armour Carol L
Graduate School of Health, University of Technology Sydney (UTS), Sydney, Australia.
Woolcock Institute of Medical Research, University of Sydney (USyd), Sydney, Australia.
BMC Med Educ. 2015 Sep 28;15:157. doi: 10.1186/s12909-015-0434-y.
Non-adherence to medicines by patients and suboptimal prescribing by clinicians underpin poor blood pressure (BP) control in hypertension. In this study, a training program was designed to enable community pharmacists to deliver a service in hypertension management targeting therapeutic adjustments and medication adherence. A comprehensive evaluation of the training program was undertaken.
Tailored training comprising a self-directed pre-work manual, practical workshop (using real patients), and practice scenarios, was developed and delivered by an inter-professional team (pharmacists, GPs). Supported by practical and written assessment, the training focused on the principles of BP management, BP measurement skills, and adherence strategies. Pharmacists' experience of the training (expectations, content, format, relevance) was evaluated quantitatively and qualitatively. Immediate feedback was obtained via a questionnaire comprising Likert scales (1 = "very well" to 7 = "poor") and open-ended questions. Further in-depth qualitative evaluation was undertaken via semi-structured interviews several months post-training (and post service implementation).
Seventeen pharmacists were recruited, trained and assessed as competent. All were highly satisfied with the training; other than the 'amount of information provided' (median score = 5, "just right"), all aspects of training attained the most positive score of '1'. Pharmacists most valued the integrated team-based approach, GP involvement, and inclusion of real patients, as well as the pre-reading manual, BP measurement workshop, and case studies (simulation). Post-implementation the interviews highlighted that comprehensive training increased pharmacists' confidence in providing the service, however, training of other pharmacy staff and patient recruitment strategies were highlighted as a need in future.
Structured, multi-modal training involving simulated and inter-professional learning is effective in preparing selected community pharmacists for the implementation of new services in the context of hypertension management. This training could be further enhanced to prepare pharmacists for the challenges encountered in implementing and evaluating services in practice.
患者不遵医嘱服药以及临床医生处方不当是高血压患者血压控制不佳的根本原因。在本研究中，设计了一项培训计划，以使社区药剂师能够提供针对治疗调整和药物依从性的高血压管理服务。对该培训计划进行了全面评估。
由跨专业团队（药剂师、全科医生）开发并提供量身定制的培训，包括一份自主学习的课前手册、实践工作坊（使用真实患者）和实践场景。在实践和书面评估的支持下，培训重点关注血压管理原则、血压测量技能和依从性策略。对药剂师的培训体验（期望、内容、形式、相关性）进行了定量和定性评估。通过包含李克特量表（1 = “非常好”至7 = “差”）和开放式问题的问卷获得即时反馈。在培训后（以及服务实施后）几个月通过半结构化访谈进行了进一步的深入定性评估。
招募、培训并评估了17名药剂师，认定他们具备能力。所有人对培训都非常满意；除了“提供的信息量”（中位数分数 = 5，“恰到好处”）外，培训的所有方面都获得了最积极的分数“1”。药剂师最看重基于团队的综合方法、全科医生的参与、真实患者的纳入，以及预习手册、血压测量工作坊和案例研究（模拟）。实施后的访谈强调，全面培训提高了药剂师提供该服务的信心，然而，未来仍需要对其他药房工作人员进行培训以及制定患者招募策略。
涉及模拟和跨专业学习的结构化多模式培训能有效地让选定的社区药剂师为在高血压管理背景下实施新服务做好准备。该培训可以进一步加强，以使药剂师为在实践中实施和评估服务时遇到的挑战做好准备。
