Munger Mark A, Walsh Michael, Godin Jon, Feehan Michael
1 Departments of Pharmacotherapy and Internal Medicine, University of Utah, Salt Lake City, Utah, USA.
2 Hall and Partners Inc, New York, NY, USA.
Ann Pharmacother. 2017 Dec;51(12):1069-1076. doi: 10.1177/1060028017722795. Epub 2017 Jul 24.
The US population continues to expand providing the need for primary health care services. Community pharmacies integrated with medicine may provide greater access while providing high quality care.
To gauge pharmacists' demand for primary health care services delivered through community pharmacies.
An online survey was administered to determine community pharmacists' preferences for varying primary care services that could be offered in the community pharmacy setting. A Discrete Choice Experiment was employed to show pharmacists competing scenarios with varied primary care service offerings in the community pharmacy setting. Attributes evaluated were operation hours, service provider, medical records, service logistics, physical examinations, point-of-care diagnostic testing, preventative care, and drug prescribing. Respondents chose the scenario most likely to induce switching employment from base pharmacy to one providing advanced services.
The optimal service delivery model from 291 community pharmacists comprised: inclusion of patient prescriptions and health information into the patient's medical record; provision of point of care testing and vital sign, including blood pressure, heart rate and breathing rate, and blood sugar and cholesterol measurement; and pharmacists prescribing (under physician oversight). Pharmacists were 4 times more likely to switch employment from their current pharmacy to their choice for advanced pharmacy services. Pharmacist demand was highest among those with a PharmD, less experience, working >40 hours per week, and in rural areas.
This study provides empirical support for the model of pharmacists playing a greater role in the provision of primary care health services through community pharmacy settings.
美国人口持续增长，对初级卫生保健服务的需求也随之增加。与医疗相结合的社区药房可能会在提供高质量护理的同时，提供更多的就医途径。
评估药剂师对通过社区药房提供的初级卫生保健服务的需求。
开展一项在线调查，以确定社区药剂师对社区药房可能提供的各种初级保健服务的偏好。采用离散选择实验，向药剂师展示社区药房环境中不同初级保健服务提供方式的竞争场景。评估的属性包括营业时间、服务提供者、病历、服务后勤、体格检查、即时诊断检测、预防保健和药物处方。受访者选择最有可能促使其从基础药房转至提供高级服务药房工作的场景。
291名社区药剂师的最佳服务提供模式包括：将患者处方和健康信息纳入患者病历；提供即时检测以及生命体征（包括血压、心率、呼吸频率、血糖和胆固醇测量）；药剂师在医生监督下开处方。药剂师从当前药房转至其选择的高级药房服务工作的可能性高出4倍。在拥有药学博士学位、经验较少、每周工作超过40小时以及在农村地区工作的药剂师中，需求最高。
本研究为药剂师通过社区药房在提供初级保健卫生服务方面发挥更大作用的模式提供了实证支持。
