Shiyanbola Olayinka O, Mott David A, Croes Kenneth D
Int J Clin Pharm. 2016 Feb;38(1):96-106. doi: 10.1007/s11096-015-0211-3.
Patients are increasingly playing an active role in healthcare and their definitions of healthcare quality are becoming more important to understand. The Donabedian model has been used to understand patients’ perceptions of quality in healthcare settings including hospitals and nursing homes; no research has applied the model to understand patients’ perceptions of pharmacy quality.
To describe older adults’ perception of a quality pharmacy including their expectations of a quality pharmacy and their preferences in a quality pharmacy.
Six focus groups held in community centers and senior residence facilities in Wisconsin.
The design was a descriptive, exploratory study. Participants were adults 65 years and older who filled a prescription at a community pharmacy in the 90 days prior to being contacted. Donabedian’s assessment of healthcare quality based on ‘structure,’ ‘process’ and ‘outcome’ was used to organize and categorize the focus group themes.
The focus groups explored older adults’ perceptions and expectations of a quality pharmacy. The factors that influenced their pharmacy choice were also examined. Results The older adults’ description of a quality pharmacy was based on the ‘structure’ and ‘process’ domain of the Donabedian model. However, most responses were focused on the ‘process’ domains and related to the application of patient-centered care (e.g., pharmacist interaction and communication) versus the structure domains (e.g., staff availability). The most frequently reported factor in the choice of pharmacies was the pharmacy’s location with some participants also reporting that their relationship and rapport with the pharmacist were also important. Older adults’ expectations were focused on the ‘process’ features of quality, including the provision of medication-related information, and the pharmacist facilitating medication safety and medication adherence.
In describing pharmacy quality, older adults mostly refer to the ‘process’ aspects of quality. Older adults perceive a quality pharmacy as one where the pharmacist provides patient-centered care. While location is important in pharmacy choices, the pharmacist’s patient-centeredness, and the quality features of the pharmacy are also relevant. Older adults’ expectations were related to their perception of a quality pharmacy. Pharmacists should publicize their pharmacies’ ‘process’ features in quality reporting systems.
患者在医疗保健中发挥的积极作用日益增强，了解他们对医疗质量的定义变得越发重要。多纳贝迪安模型已被用于理解患者对包括医院和疗养院在内的医疗环境中质量的看法；尚无研究应用该模型来理解患者对药房质量的看法。
描述老年人对优质药房的认知，包括他们对优质药房的期望以及在优质药房方面的偏好。
在威斯康星州的社区中心和老年居住设施中举行了六个焦点小组。
该设计为描述性探索性研究。参与者为65岁及以上的成年人，他们在被联系前的90天内在社区药房配过药。基于“结构”“过程”和“结果”的多纳贝迪安医疗质量评估用于组织和分类焦点小组主题。
焦点小组探讨了老年人对优质药房的认知和期望。还研究了影响他们选择药房的因素。结果老年人对优质药房的描述基于多纳贝迪安模型的“结构”和“过程”领域。然而，大多数回答集中在“过程”领域，且与以患者为中心的护理应用（如药剂师互动和沟通）相关，而非结构领域（如工作人员可用性）。在选择药房时最常报告的因素是药房的位置，一些参与者还报告称他们与药剂师的关系和融洽程度也很重要。老年人的期望集中在质量的“过程”特征上，包括提供与药物相关的信息，以及药剂师促进用药安全和药物依从性。
在描述药房质量时，老年人大多提及质量的“过程”方面。老年人将优质药房视为药剂师提供以患者为中心护理的药房。虽然位置在药房选择中很重要，但药剂师以患者为中心的程度以及药房的质量特征也很相关。老年人的期望与他们对优质药房的认知有关。药剂师应在质量报告系统中宣传其药房的“过程”特征。
