Puspitasari Hanni P, Aslani Parisa, Krass Ines
Lecturer at Universitas Airlangga, Fakultas Farmasi in Surabaya, East Java Province ( Indonesia ).
Faculty of Pharmacy, University of Sydney . Sydney, NSW ( Australia ).
Pharm Pract (Granada). 2015 Apr-Jun;13(3):578. doi: 10.18549/PharmPract.2015.03.578. Epub 2015 Jun 15.
We explored factors influencing Indonesian primary care pharmacists' practice in chronic noncommunicable disease management and proposed a model illustrating relationships among factors.
We conducted in-depth, semistructured interviews with pharmacists working in community health centers (Puskesmas, n=5) and community pharmacies (apotek, n=15) in East Java Province. We interviewed participating pharmacists using Bahasa Indonesia to explore facilitators and barriers to their practice in chronic disease management. We audiorecorded all interviews, transcribed ad verbatim, translated into English and analyzed the data using an approach informed by "grounded-theory".
We extracted five emergent themes/factors: pharmacists' attitudes, Puskesmas/apotek environment, pharmacy education, pharmacy professional associations, and the government. Respondents believed that primary care pharmacists have limited roles in chronic disease management. An unfavourable working environment and perceptions of pharmacists' inadequate knowledge and skills were reported by many as barriers to pharmacy practice. Limited professional standards, guidelines, leadership and government regulations coupled with low expectations of pharmacists among patients and doctors also contributed to their lack of involvement in chronic disease management. We present the interplay of these factors in our model.
Pharmacists' attitudes, knowledge, skills and their working environment appeared to influence pharmacists' contribution in chronic disease management. To develop pharmacists' involvement in chronic disease management, support from pharmacy educators, pharmacy owners, professional associations, the government and other stakeholders is required. Our findings highlight a need for systematic coordination between pharmacists and stakeholders to improve primary care pharmacists' practice in Indonesia to achieve continuity of care.
我们探讨了影响印度尼西亚初级保健药剂师在慢性非传染性疾病管理中实践的因素，并提出了一个说明各因素之间关系的模型。
我们对东爪哇省社区卫生中心（公共卫生中心，n = 5）和社区药房（药店，n = 15）工作的药剂师进行了深入的半结构化访谈。我们用印尼语采访参与的药剂师，以探讨他们在慢性病管理实践中的促进因素和障碍。我们对所有访谈进行了录音，逐字转录，翻译成英语，并使用基于“扎根理论”的方法分析数据。
我们提取了五个新出现的主题/因素：药剂师的态度、公共卫生中心/药店环境、药学教育、药学专业协会和政府。受访者认为初级保健药剂师在慢性病管理中的作用有限。许多人报告说，不利的工作环境以及对药剂师知识和技能不足的看法是药学实践的障碍。有限的专业标准、指南、领导力和政府法规，再加上患者和医生对药剂师的期望较低，也导致他们缺乏对慢性病管理的参与。我们在模型中展示了这些因素的相互作用。
药剂师的态度、知识、技能及其工作环境似乎影响着药剂师在慢性病管理中的贡献。要提高药剂师对慢性病管理的参与度，需要药学教育工作者、药店老板、专业协会、政府和其他利益相关者的支持。我们的研究结果强调，药剂师与利益相关者之间需要进行系统协调，以改善印度尼西亚初级保健药剂师的实践，实现连续护理。
