Saw Pui S, Nissen Lisa, Freeman Christopher, Wong Pei S, Mak Vivienne
School of Pharmacy, Monash University Malaysia. Selangor (Malaysia).
Professor and Head, School of Clinical Sciences, Queensland University of Technology, Brisbane QLD (Australia).
Pharm Pract (Granada). 2017 Jul-Sep;15(3):971. doi: 10.18549/PharmPract.2017.03.971. Epub 2017 Sep 2.
Private general practitioners in Malaysia largely operates as solo practices - prescribing and supplying medications to patients directly from their clinics, thus posing risk of medication-related problems to consumers. A pharmacy practice reform that integrates pharmacists into primary healthcare clinics can be a potential initiative to promote quality use of medication. This model of care is a novel approach in Malaysia and research in the local context is required, especially from the perspectives of pharmacists.
To explore pharmacists' views in integrating pharmacists into private GP clinics in Malaysia.
A combination of purposive and snowballing sampling was used to recruit community and hospital pharmacists from urban areas in Malaysia to participate either in focus groups or semi-structured interviews. A total of 2 focus groups and 4 semi-structured interviews were conducted. Sessions were audio recorded, transcribed verbatim and thematically analysed using NVivo 10.
Four major themes were identified: (1) Limited potential to expand pharmacists' roles, (2) Concerns about non-pharmacists dispensing medicines in private GP clinics, (3) Lack of trust from consumers and private GPs, (4) Cost implications. Participants felt that there was a limited role for pharmacists in private GP clinics. This was because the medication supply role is currently undertaken in private GP clinics without the need of pharmacists. The perceived lack of trust from consumers and private GPs towards pharmacists arises from the belief that healthcare is the GPs' responsibility. This suggests that there is a need for increased public and GP awareness towards the capabilities of pharmacists' in medication management. Participants were concerned about an increase in cost to private GP visits if pharmacists were to be integrated. Nevertheless, some participants perceived the integration as a means to reduce medical costs through improved quality use of medicines.
Findings from the study provided a better understanding to help ascertain pharmacists' views on their readiness and acceptance in a potential new model of practice.
马来西亚的私人全科医生大多独立执业,直接在诊所为患者开药和供药,这给消费者带来了药物相关问题的风险。将药剂师纳入基层医疗诊所的药房实践改革可能是促进合理用药的一项潜在举措。这种护理模式在马来西亚是一种新方法,需要在当地背景下进行研究,尤其是从药剂师的角度。
探讨药剂师对将药剂师纳入马来西亚私人全科医生诊所的看法。
采用目的抽样和滚雪球抽样相结合的方法,招募马来西亚城市地区的社区和医院药剂师参加焦点小组或半结构式访谈。共进行了2个焦点小组和4次半结构式访谈。会议进行了录音,逐字转录,并使用NVivo 10进行主题分析。
确定了四个主要主题:(1)药剂师角色扩展潜力有限;(2)对私人全科医生诊所中非药剂师配药的担忧;(3)消费者和私人全科医生缺乏信任;(4)成本影响。参与者认为药剂师在私人全科医生诊所中的作用有限。这是因为目前私人全科医生诊所承担了药品供应角色,无需药剂师参与。消费者和私人全科医生对药剂师缺乏信任,是因为他们认为医疗保健是全科医生的职责。这表明需要提高公众和全科医生对药剂师在药物管理方面能力的认识。参与者担心如果纳入药剂师,私人全科医生就诊成本会增加。然而,一些参与者认为整合是通过改善药物合理使用来降低医疗成本的一种手段。
该研究结果有助于更好地理解药剂师对一种潜在新实践模式的准备情况和接受程度的看法。