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探索处方药建议的普及率及相关因素:对英国一个城市社区药房的调查

Exploring the prevalence of and factors associated with advice on prescription medicines: A survey of community pharmacies in an English city.

作者信息

Rivers Peter H, Waterfield Jon, Grootveld Martin, Raynor David K

机构信息

Leicester School of Pharmacy, De Montfort University, Leicester, UK.

School of Healthcare, University of Leeds, Leeds, UK.

出版信息

Health Soc Care Community. 2017 Nov;25(6):1774-1786. doi: 10.1111/hsc.12451. Epub 2017 May 9.

Abstract

Service users rely upon pharmacy staff to provide advice on prescription medicines. The purpose of this study was to compare the prevalence of advice-giving in pharmacies located across different areas within an inner-city population. A questionnaire was administered with service users outside 29 community pharmacies in an English Midlands city between February and July 2014. The primary outcome measure was the percentage who had received information or advice when collecting a prescription medicine. A total of 1206 service users took part, of whom 49.1% were female and 50.9% were of minority ethnicity (48.8% white British). The age ranges were: 17-30 years (21.0%), 31-60 years (55.0%) and 61-80+ years (24.1%). Sixty-nine per cent of participants had collected a prescription for themselves, and the proportions of new and repeat prescriptions were 22.1% and 77.6% respectively. A subset of 141 participants had requested advice, of whom 94% confirmed that they had received it. Overall, 28.6% of 1065 participants received unsolicited information or advice. The overall prevalence of unsolicited advice-giving varied per pharmacy from 14% to 63% and for new and repeat prescriptions was 41.9% and 25.5% respectively (p < .001, new vs repeat). In areas of greater deprivation, a higher proportion of service users of minority ethnicity received unsolicited repeat prescription advice, compared to that of white British (33.0% vs 17.3% respectively; p < .001). Thus, the low incidence and contrasting patterns of prescription advice-giving suggests that the training and expertise of pharmacy staff may not always be used effectively within the UK NHS. Therefore, the current challenge is how community pharmacies can work in partnership with colleagues across the wider healthcare system when optimising the use of medicines and reducing health inequalities. The research performed here provides new insights reflecting the low prevalence of advice-giving and potential inequity associated with delivery of this pharmacy service.

摘要

服务使用者依靠药房工作人员提供有关处方药的建议。本研究的目的是比较位于市中心城区不同区域的药房提供建议的普遍程度。2014年2月至7月期间,在英格兰中部一座城市的29家社区药房外向服务使用者发放了调查问卷。主要结果指标是在领取处方药时获得信息或建议的人所占的百分比。共有1206名服务使用者参与,其中49.1%为女性,50.9%为少数族裔(48.8%为英国白人)。年龄范围为:17 - 30岁(21.0%)、31 - 60岁(55.0%)和61 - 80岁及以上(24.1%)。69%的参与者为自己领取处方,新处方和重复处方的比例分别为22.1%和77.6%。141名参与者的一个子集中有部分人寻求了建议,其中94%确认他们得到了建议。总体而言,1065名参与者中有28.6%收到了主动提供的信息或建议。各药房主动提供建议的总体普遍程度从14%到63%不等,新处方和重复处方的比例分别为41.9%和25.5%(p <.001,新处方与重复处方)。在贫困程度较高的地区,与英国白人相比,少数族裔服务使用者中收到主动提供的重复处方建议的比例更高(分别为33.0%和17.3%;p <.001)。因此,处方建议提供的低发生率和不同模式表明,在英国国民医疗服务体系中,药房工作人员的培训和专业知识可能并未总是得到有效利用。所以,当前的挑战是社区药房在优化药物使用和减少健康不平等现象时,如何与更广泛医疗体系中的同事合作。此处开展的研究提供了新的见解,反映了建议提供的低普遍程度以及与这项药房服务提供相关的潜在不公平现象。

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