Faculty of Pharmacy, The University of Sydney, NSW Australia; Faculty of Pharmacy, Airlangga University Indonesia.
Faculty of Arts and Social Sciences, The University of Sydney, NSW Australia.
Res Social Adm Pharm. 2018 Dec;14(12):1147-1156. doi: 10.1016/j.sapharm.2018.02.003. Epub 2018 Feb 15.
The nature of community pharmacy in many countries has changed. Despite the significant efforts made to change practice, there is a paucity of literature that highlights consensus on the approaches that should be prioritised for advancing practice particularly in the context of developing countries.
To systematically identify and prioritise a range of potential recommendations to improve practice in Indonesian community pharmacy from the perspective of pharmacy stakeholders.
Qualitative research using Nominal Group Technique (NGT) was conducted in July 2017 involving 34 nationwide pharmacy stakeholders. Participants were assigned to four nominal group discussions based on the areas for action as developed by researchers. The results were thematically analysed.
Nine priority recommendations were generated from the group discussion reflecting four main themes to advance community pharmacy sector, namely improving professional pharmacy practice, reforming pharmacy education, enforcing policy and regulation and enhancing public recognition of pharmacists. The analysis using the culture-structure-agency approach highlights that the top down structure in terms of policy and regulatory framework has not been effectively enforced. In addition, the role of pharmacists as the central agency in delivering pharmacy services has been limited due to their common absence from practice. The approach, however, provides an alternative to advocate changes by locating the role of pharmacists and community pharmacy as central agency within the challenging health system structure.
The recommendations generated from and approach used in this study provide an impetus to advance community pharmacy practice in Indonesia. Amongst the important solutions, there is substantial need to provide evidence of pharmacists' contribution to healthcare.
许多国家的社区药房性质已经发生了变化。尽管为改变实践做出了重大努力，但关于应优先考虑哪些方法来推进实践的文献却很少，尤其是在发展中国家的背景下。
从药剂师利益相关者的角度系统地确定和优先考虑一系列潜在建议，以改善印度尼西亚社区药房的实践。
2017 年 7 月，采用名义小组技术（NGT）进行了定性研究，涉及 34 名全国性的药剂师利益相关者。根据研究人员制定的行动领域，参与者被分配到四个名义小组讨论中。结果进行了主题分析。
从小组讨论中产生了 9 项优先建议，反映了推进社区药房部门的四个主要主题，即提高专业药房实践水平、改革药房教育、加强政策和法规以及提高公众对药剂师的认可。使用文化-结构-机构方法的分析表明，在政策和监管框架方面的自上而下的结构尚未得到有效执行。此外，由于药剂师普遍不在实践中，药剂师作为提供药学服务的核心机构的作用受到限制。然而，这种方法提供了一种替代方案，通过将药剂师和社区药房的作用定位为核心机构，在具有挑战性的卫生系统结构中倡导变革。
本研究提出的建议和使用的方法为印度尼西亚推进社区药房实践提供了动力。在提出的重要解决方案中，有大量需要提供药剂师对医疗保健贡献的证据。
