Faculty of Pharmacy, Yarmouk University, Irbid, Jordan.
Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB, Canada. Electronic address: lisa.guirguis@ualberta.
Res Social Adm Pharm. 2018 Jun;14(6):564-571. doi: 10.1016/j.sapharm.2017.07.002. Epub 2017 Jul 15.
The patient care process (PCP) was adopted to move community pharmacy practice from the traditional dispensing role to a more professional level of patient care. However, research has not yet empirically characterized how pharmacists conduct the PCP in community pharmacies.
This study characterizes how pharmacists employ the PCP when evaluating medication appropriateness in a simulated community pharmacy setting.
A mixed methods analysis was employed to analyze simulated patient-pharmacist interactions (i.e., consultations), and concurrent think-aloud (checking sessions). Transcripts were quantitatively coded for elements of the PCP. A generic qualitative approach was used to explore how pharmacists provided care.
Almost all pharmacists checked for medication indication, safety, and manageability at the end of the process when releasing the medication to the patient. Still, most pharmacists gathered insufficient information to fully evaluate medication appropriateness. Six overarching themes described consultations and checking sessions: missed opportunities, the absence of personalized assessments, reliance on routines, nonspecific questions, communication style, and response to patient cues. The quantitative and qualitative findings together created a picture of incomplete assessments which were driven by technical routines and medication-focused communication.
Overall, the majority of pharmacists completed most of the patient-care process. Even so, pharmacists did not complete a full assessment of medication appropriateness. Patient care tasks were driven by routines and occurred at the end of the process, whereas the initial patient assessment and prescription check were mainly devoted to technical activities. Pharmacists had opportunities to enhance patient-centered communication by engaging patients in dialogue and recognizing patient emotional cue.
患者关怀流程（PCP）被采用，以将社区药房实践从传统的配药角色提升到更专业的患者关怀水平。然而，研究尚未从实证角度描述药剂师在社区药房中如何实施 PCP。
本研究描述了药剂师在模拟社区药房环境中评估药物适宜性时如何运用 PCP。
采用混合方法分析，对模拟患者-药剂师互动（即咨询）和并发的思考 aloud（检查会话）进行分析。对 PCP 的元素进行定量编码。采用通用的定性方法来探索药剂师如何提供关怀。
几乎所有药剂师在将药物发放给患者时，都会在流程结束时检查药物的适应证、安全性和可管理性。然而，大多数药剂师收集的信息不足以全面评估药物适宜性。六个总体主题描述了咨询和检查会话：错失机会、缺乏个性化评估、依赖常规、非特定问题、沟通风格和对患者提示的反应。定量和定性的发现共同描绘了不完整评估的情况，这些评估受到技术常规和以药物为中心的沟通的驱动。
总体而言，大多数药剂师完成了大部分患者关怀流程。即便如此，药剂师仍未完成对药物适宜性的全面评估。患者关怀任务由常规驱动，并发生在流程结束时，而初始患者评估和处方检查主要侧重于技术活动。药剂师有机会通过与患者进行对话并识别患者的情感提示，增强以患者为中心的沟通。
