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社区药剂师对糖尿病管理中共同决策的看法。

Community pharmacists' perspectives on shared decision-making in diabetes management.

作者信息

Rosenberg-Yunger Zahava R S, Verweel Lee, Gionfriddo Michael R, MacCallum Lori, Dolovich Lisa

机构信息

Ted Rogers School of Management, Health Services Management, Ryerson University, Toronto, ON, Canada.

Ontario Pharmacists Association, Toronto, ON, Canada.

出版信息

Int J Pharm Pract. 2018 Oct;26(5):414-422. doi: 10.1111/ijpp.12422. Epub 2017 Dec 26.

Abstract

OBJECTIVES

Shared decision-making (SDM) is an approach where patients and clinicians share evidence and patients are supported to deliberate options resulting in preference-based informed decisions. The aim of this study was to describe community pharmacists' perceptions and awareness of SDM within their provision of general diabetes management [including Ontario's MedsCheck for Diabetes (MCD) programme], and potential challenges of implementing SDM within community pharmacy.

METHODS

This qualitative study used semistructured interviews with a convenience sample of community pharmacists. Data were analysed using thematic analysis.

KEY FINDINGS

We conducted 16 interviews. Six participants were male, and nine were certified diabetes educators. When providing a MCD, participants used aspects of a patient-centred approach focusing on providing education. Variation was evident in participants' description and use of SDM, as well as in their perceived level of training in SDM. Participants also highlighted challenges surrounding implementing a SDM approach in practice.

CONCLUSION

Pharmacists are well positioned to apply SDM within community settings; however, implementation barriers exist. Pharmacists will require additional training as well as perceived patient and physician barriers should be addressed to encourage uptake.

摘要

目的

共同决策(SDM)是一种患者和临床医生共享证据,并支持患者对各种选择进行权衡,从而做出基于偏好的明智决策的方法。本研究的目的是描述社区药剂师在提供一般糖尿病管理服务(包括安大略省的糖尿病药物检查计划)过程中对共同决策的认知和了解,以及在社区药房实施共同决策可能面临的挑战。

方法

本定性研究采用半结构化访谈,对社区药剂师进行便利抽样。采用主题分析法对数据进行分析。

主要发现

我们进行了16次访谈。6名参与者为男性,9名是认证糖尿病教育者。在提供糖尿病药物检查服务时,参与者采用了以患者为中心的方法,重点是提供教育。参与者对共同决策的描述和使用,以及他们所认为的共同决策培训水平存在明显差异。参与者还强调了在实践中实施共同决策方法所面临的挑战。

结论

药剂师在社区环境中应用共同决策具有优势;然而,实施障碍依然存在。药剂师需要接受额外培训,同时应消除患者和医生方面的认知障碍,以促进共同决策的采用。

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