d'Elbée M, Baumevieille M, Dumartin C
London School of Hygiene and Tropical Medicine, 15-17, Tavistock Place, London WC1H 9SH, Royaume-Uni.
Droit et économie pharmaceutiques, UFR des sciences pharmaceutiques, université de Bordeaux, 33076 Bordeaux, France; Inserm U 1219, santé des populations, pharmaco-épidémiologie et impact des produits de santé sur les populations, 33076 Bordeaux, France.
Rev Epidemiol Sante Publique. 2017 Jun;65(3):231-239. doi: 10.1016/j.respe.2017.01.002. Epub 2017 Mar 3.
In 2009, the French Act "Hospital, Patients, Health and Territories" (loi "Hôpital, Patients, Santé et Territoires") reorganized the outpatient care pathway and defined missions aimed at improving cooperation between pharmaceutical and medical professionals. Five years later, we conducted a survey among community pharmacists in order to assess the appropriation of these missions and the way cooperation was implemented. We also aimed to investigate factors that could hamper or ease the development of these activities in order to identify actions needed to improve pharmacists' involvement.
In partnership with the local health authorities "Agence régionale de santé", we conducted a survey via an online questionnaire sent to pharmacy holders in July 2014 in Aquitaine region. Information was collected about the pharmacies, involvement in collaborative activities, and barriers to cooperation.
Overall, 20% (249) of pharmacists responded to the survey. They owned predominantly rural pharmacies (46%) or neighborhood pharmacies (41%), with two pharmacists per pharmacy (48%). Regarding collaborative activities, the majority of pharmacists (78%) had conducted interviews with their patients taking vitamin K antagonist therapy and they were willing to continue (87%). The implication was less common concerning other actions such as referent pharmacist for nursing homes (19%) or activities relating to therapeutic educational programs for patients with chronic conditions (34%). The vast majority of respondents (85%) were not aware of opportunities to become a correspondent pharmacist. The main obstacles for engaging in these activities were the lack of time, lack of knowledge about these missions and the lack of remuneration. We identified differences in pharmacists' involvement in collaborative activities depending on selected characteristics of the pharmacies.
The findings of this survey underlined pharmacists' acceptance of these missions and suggest that better information and appropriate remuneration could enhance commitment. Recent changes in the legal framework (establishment of "pharmaceutical fees", extension of the scope of pharmaceutical interviews) enable funding for collaborative practices between medical practitioners and pharmacists, thus encouraging better coordination in the patient care pathway.
2009年，法国的《医院、患者、健康与地区法案》（“医院、患者、健康与地区”法）重新组织了门诊护理流程，并确定了旨在改善药学专业人员与医学专业人员之间合作的任务。五年后，我们对社区药剂师进行了一项调查，以评估这些任务的落实情况以及合作的实施方式。我们还旨在调查可能阻碍或促进这些活动开展的因素，以便确定提高药剂师参与度所需采取的行动。
我们与当地卫生当局“地区卫生机构”合作，于2014年7月通过在线问卷对阿基坦地区的药房经营者进行了一项调查。收集了有关药房、参与合作活动情况以及合作障碍的信息。
总体而言，20%（249名）药剂师回复了调查。他们主要经营乡村药房（46%）或社区药房（41%），每家药房有两名药剂师（48%）。关于合作活动，大多数药剂师（78%）对接受维生素K拮抗剂治疗的患者进行了访谈，并且他们愿意继续（87%）。对于其他行动，如养老院指定药剂师（19%）或慢性病患者治疗教育项目相关活动（34%），参与度较低。绝大多数受访者（85%）不知道有机会成为通讯员药剂师。参与这些活动的主要障碍是时间不足、对这些任务缺乏了解以及缺乏报酬。我们发现，根据药房的选定特征，药剂师在合作活动中的参与情况存在差异。
本次调查结果强调了药剂师对这些任务的接受程度，并表明更好的信息和适当的报酬可以增强他们的参与度。法律框架最近的变化（设立“药学费用”、扩大药学访谈范围）为医生和药剂师之间的合作实践提供了资金支持，从而鼓励在患者护理流程中进行更好的协调。
