关键利益相关者对补充药物药学实践的障碍及解决方案的看法：澳大利亚的经验
Key stakeholder perspectives on the barriers and solutions to pharmacy practice towards complementary medicines: an Australian experience.
作者信息
Ung Carolina Oi Lam, Harnett Joanna, Hu Hao
机构信息
State Key Lab of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Room 2057, N22 Research Building, Macao, China.
Faulty of Pharmacy, The University of Sydney, A15 - Pharmacy And Bank Building, Sydney, NSW, Australia.
出版信息
BMC Complement Altern Med. 2017 Aug 9;17(1):394. doi: 10.1186/s12906-017-1899-5.
BACKGROUND
Although pharmacists are entrusted to play a role in ensuring the safe and appropriate use of all medicines, in general, the inclusion of complementary medicines (CMs) into their professional practice has not been observed. The purpose of this study was to explore the perceptions and opinions of pharmacists and 8 key stakeholder leaders regarding the barriers that hinder pharmacists from providing care related to the use of CMs by patients/consumers and to identify solutions that would support pharmacists' in extending their role in this area.
METHODS
Semi-structured key informant interviews were conducted with 2 practicing pharmacists, 1 pharmacy owner, 1 key representative of a pharmacist professional organization, 1 key representative of a consumer advocacy group, 1 key representative of a medical professional organization, 1 key representative from a complementary medicine practitioner professional organization, 1 leader within a pharmacy school, 2 senior staff from a regulatory authority, and 1 key representative of the complementary medicine industry in Australia.
RESULTS
A total of 9 barriers were identified in this study. Barriers including a lack of CMs knowledge, doubts about the evidence-base, a lack of research skills and access to reliable and reputable information dominated the discussions. A total of 7 solutions were proposed. Of those, the integration of CMs curricula into under-graduate and professional pharmacy education, and defining a clearer role for pharmacists' standard of practice were considered the most important. Apposing opinions about the role of naturopaths in pharmacies were identified..
CONCLUSION
It is anticipated that pharmacists will be required to formalise a role in ensuring the safe and appropriate use of complementary medicines to fulfil their professional and ethical responsibilities. However, pharmacists in general are not ready to take up this extended role. Individual key stakeholder groups have considered the existing barriers and have proposed solutions that are isolated measures. To facilitate further developments related to CMs and the professional practice of pharmacy, collaborative efforts between key stakeholders are needed to strategically plan and execute an extended role in a unified manner.
背景
尽管药剂师被委以确保所有药物安全合理使用的职责，但总体而言，补充药物（CMs）在其专业实践中的应用情况尚未得到关注。本研究旨在探讨药剂师以及8位关键利益相关方领导者对于阻碍药剂师为患者/消费者提供与CMs使用相关护理的障碍的看法和意见，并确定有助于药剂师在这一领域拓展职责的解决方案。
方法
对2名执业药剂师、1名药房老板、1名药剂师专业组织的关键代表、1名消费者权益倡导组织的关键代表、1名医学专业组织的关键代表、1名补充药物从业者专业组织的关键代表、1名药学院领导、2名监管机构高级工作人员以及1名澳大利亚补充药物行业关键代表进行了半结构化关键信息访谈。
结果
本研究共确定了9个障碍。讨论中主要涉及缺乏CMs知识、对循证依据的怀疑、缺乏研究技能以及难以获取可靠和权威信息等障碍。共提出了7个解决方案。其中，将CMs课程纳入本科和专业药学教育，以及为药剂师的实践标准明确更清晰的职责被认为是最重要的。还发现了关于自然疗法从业者在药房中角色的不同意见。
结论
预计将要求药剂师在确保补充药物安全合理使用方面正式履行职责，以履行其专业和道德责任。然而，总体而言药剂师尚未准备好承担这一扩展职责。各个关键利益相关方团体已考虑了现有障碍并提出了一些孤立的解决措施。为促进与CMs以及药学专业实践相关的进一步发展，关键利益相关方需要共同努力，以统一的方式进行战略规划并执行扩展职责。
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