a Department of Pharmacy Practice , East Tennessee State University Gatton College of Pharmacy , Johnson City , Tennessee , USA.
b Department of Family Medicine , East Tennessee State University Quillen College of Medicine , Johnson City , Tennessee , USA.
Subst Abus. 2018 Jan 2;39(1):89-94. doi: 10.1080/08897077.2017.1365803. Epub 2017 Sep 15.
Prescribers and community pharmacists commonly perceive prescription opioid abuse to be a problem in their practice settings and communities. Both cohorts have expressed support for interventions that improve interprofessional communication and reduce prescription opioid abuse. The objective of this study was to describe prescription opioid abuse-related communication among and between prescribers and community pharmacists in South Central Appalachia.
The investigators conducted five focus groups with 35 Appalachian Research Network practice-based research network providers between February and October, 2014. Two prescriber-specific, two pharmacist-specific, and one interprofessional (prescribers and pharmacists) focus groups were conducted, recorded, and transcribed. Data collection and analysis occurred iteratively. Emerging themes were inductively derived and refined. Five member-checking interviews were conducted to validate themes.
Providers noted several factors that influence intraprofessional and interprofessional communication, including level of trust, role perceptions, conflict history and avoidance, personal relationships, and prescription monitoring program use. Indirect communication approaches via patients, office staff, and voicemail systems were common. Direct pharmacist to prescriber and prescriber to pharmacist communication was described as rare and often perceived to be ineffective. Prescriber to pharmacist communication was reported by prescribers to have decreased after implementation of state prescription monitoring programs. Difficult or uncomfortable conversations were often avoided by providers.
Interprofessional and intraprofessional prescription opioid abuse communication is situational and influenced by multiple factors. Indirect communication and communication avoidance are common. Themes identified in this study can inform development of interventions that improve providers' intra- and interprofessional communication skills.
在实践环境和社区中，医生和社区药剂师普遍认为处方类阿片类药物滥用是一个问题。这两个群体都支持可以改善专业间沟通和减少处方类阿片类药物滥用的干预措施。本研究的目的是描述美国阿巴拉契亚中南部地区医生和社区药剂师之间与处方类阿片类药物滥用相关的沟通情况。
研究人员于 2014 年 2 月至 10 月期间，对阿巴拉契亚研究网络实践研究网络的 35 名提供者进行了 5 次焦点小组讨论。进行了 2 次医生特定、2 次药剂师特定和 1 次专业间（医生和药剂师）焦点小组讨论，对讨论内容进行了记录和转录。数据收集和分析是迭代进行的。出现的主题是通过归纳法得出并不断完善的。进行了 5 次成员核对访谈，以验证主题。
提供者指出了影响专业内和专业间沟通的几个因素，包括信任程度、角色认知、冲突历史和回避、个人关系以及处方监测计划的使用。通过患者、办公室工作人员和语音邮件系统进行间接沟通的方法很常见。直接的药剂师与医生以及医生与药剂师之间的沟通则很少见，并且通常被认为效果不佳。报告称，在实施州处方监测计划后，医生与药剂师之间的沟通减少了。提供者经常避免进行困难或不适的对话。
专业间和专业内的处方类阿片类药物滥用沟通是情境性的，受多种因素影响。间接沟通和沟通回避很常见。本研究中确定的主题可以为改善提供者的专业间和专业内沟通技巧的干预措施提供信息。
