Faculty of Pharmacy, University of Sydney, Sydney, New South Wales, Australia.
Faculty of Pharmacy, Uppsala University, Uppsala, Sweden.
Res Social Adm Pharm. 2018 Jan;14(1):31-45. doi: 10.1016/j.sapharm.2016.12.010. Epub 2017 Jan 10.
A core role of the pharmacist is to ensure safe and effective medication use. Therapeutic classes that impair alertness (e.g. sedatives or hypnotics) can pose safety concerns for the consumer when undertaking activities requiring psychomotor vigilance (e.g. driving).
To explore pharmacists' perceptions and communication strategy of the risks related to alertness impairing medications in clinical practice.
In-depth semi-structured interviews explored community pharmacists' perceptions of medication-related risks, current medication provision and the feasibility of new practice tools. Interviews were digitally recorded, transcribed verbatim and analysed using Framework Analysis to identify emergent themes. A Psychometric Risk Perception Questionnaire was also used to evaluate pharmacists' perceptions across 7 common psychotropic drug classes.
Synthesis of the qualitative dataset of 30 pharmacist interviews revealed three key themes: 'Safety and Consequences of AIMs', 'Factors that Influence Risk Communication' and 'Refining Risk Communication'. Participating pharmacists were generally aware of the therapeutic classes associated with medication-related risks but were concerned about patients' level of understanding. Counselling approaches were largely dictated by perceived patient interest/experience with a medication. Concerns were centred on inter-individual pharmacokinetic differences, which could make the precise risk assignment difficult. Pharmacists also highlighted workflow limitations and the need to bring patients' attention to these resources during the clinical interaction to maximise impact.
Medication-related risk communication is a complex clinical phenomenon dictated by patients' prior experiences and the pharmacists' practice environment. Extending the evidence base in this therapeutic area and refining clinical resources are key steps towards optimising patient medication safety.
药剂师的核心作用是确保药物使用安全有效。影响警觉性的治疗类别(如镇静剂或催眠药)在从事需要精神警觉性的活动(如驾驶)时,会对消费者的安全构成担忧。
探讨药剂师在临床实践中对警觉性损害药物相关风险的看法和沟通策略。
深入的半结构化访谈探讨了社区药剂师对与药物相关的风险、当前药物提供以及新实践工具的可行性的看法。访谈以数字方式记录、逐字转录,并使用框架分析进行分析,以确定出现的主题。还使用了心理测量风险感知问卷来评估药剂师对 7 种常见精神药物类别的感知。
对 30 名药剂师访谈的定性数据集的综合分析揭示了三个关键主题:“AIMs 的安全性和后果”、“影响风险沟通的因素”和“完善风险沟通”。参与的药剂师通常意识到与药物相关风险相关的治疗类别,但担心患者的理解程度。咨询方法主要取决于感知到的患者对药物的兴趣/经验。关注的焦点是个体间药代动力学的差异,这使得准确分配风险变得困难。药剂师还强调了工作流程的限制,以及在临床互动中需要引起患者对这些资源的注意,以最大限度地提高影响。
药物相关风险沟通是一个复杂的临床现象,取决于患者的既往经验和药剂师的实践环境。在这一治疗领域扩展证据基础并完善临床资源是优化患者药物安全的关键步骤。