Department of Pharmaceutical Care and Health Systems, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota.
Alliance for Integrated Medication Management, Minneapolis, Minnesota.
Pharmacotherapy. 2018 Jan;38(1):69-79. doi: 10.1002/phar.2062. Epub 2017 Dec 18.
Philosophy of practice is the foundation of any patient care practice because it provides a set of professional values and beliefs that guide actions and decisions in practice. Study objectives were to understand how pharmacists providing comprehensive medication management (CMM) describe their philosophy of practice and compare how participants' philosophies align with predefined tenets of a CMM philosophy of practice.
An instrument with closed and open-ended items was developed and administered online to the lead pharmacist at 36 clinics participating in a large CMM study. Participants were asked to describe their philosophy of practice, rate how well their current practice activities align with five predefined CMM philosophy of practice tenets, and provide examples of how they carry out each tenet and how they could improve. Responses were coded, and descriptive analysis was used to calculate participants' practice alignment with the five philosophy of practice tenets.
Thirty pharmacists completed the instrument. Twelve codes emerged that participants used to describe their philosophy of practice. These codes were mapped to five predefined tenets of a philosophy of practice. Only 3 (10%) participants included all five tenets in their philosophy of practice, 8 (26.7%) included four, 8 (26.7%) included three, 6 (20%) included two, and 5 (16.7%) included one tenet. Overall, participants rated their alignment with the five tenets highly. "Embracing a patient-centered approach" received the highest mean score of 9.17/10; "Meeting a societal need" had the lowest mean score of 8.37/10.
Participants described their philosophy of practice with significant variability. CMM requires a single and consistently applied philosophy of practice to guide practice and the role of the practitioner. We propose five core tenets that resulted from this assessment to be embraced by pharmacists providing CMM and included in their philosophy of practice.
实践哲学是任何患者护理实践的基础，因为它提供了一套专业价值观和信念，指导实践中的行动和决策。研究目的是了解提供全面药物管理（CMM）的药剂师如何描述他们的实践哲学，并比较参与者的哲学如何与 CMM 实践哲学的既定原则保持一致。
开发了一种带有封闭式和开放式项目的工具，并在线分发给参与大型 CMM 研究的 36 个诊所的首席药剂师。参与者被要求描述他们的实践哲学，评估他们目前的实践活动与五个预先定义的 CMM 实践哲学原则的一致性，并提供他们如何执行每个原则以及如何改进的例子。对回复进行编码，并使用描述性分析来计算参与者与五个实践哲学原则的实践一致性。
30 名药剂师完成了该工具。参与者用来描述他们的实践哲学的 12 个代码出现了。这些代码被映射到实践哲学的五个预先定义的原则。只有 3 名（10%）参与者在他们的实践哲学中包含了所有五个原则，8 名（26.7%）包括四个，8 名（26.7%）包括三个，6 名（20%）包括两个，5 名（16.7%）包括一个原则。总体而言，参与者对五个原则的一致性评价很高。“采用以患者为中心的方法”获得了最高的平均分数 9.17/10；“满足社会需求”的平均得分最低，为 8.37/10。
参与者对他们的实践哲学描述具有很大的差异。CMM 需要一个单一且一致应用的实践哲学来指导实践和从业者的角色。我们提出了五个核心原则，这些原则来自于这项评估，供提供 CMM 的药剂师采纳并纳入他们的实践哲学。
