Division of Pharmacy, School of Medicine, Faculty of Health, University of Tasmania, Private Bag 26, Hobart 7001, Australia. Email:
Division of Pharmacy, School of Medicine, Faculty of Health, University of Tasmania, Hobart, Australia.
Prev Chronic Dis. 2018 Jun 14;15:E81. doi: 10.5888/pcd15.170485.
Community pharmacists are well positioned to deliver chronic kidney disease (CKD) screening services. However, little is known about the challenges faced by pharmacists during service implementation. This study aimed to explore community pharmacists' experiences and perceived barriers of implementing a CKD risk assessment service.
Data collection was performed by using semistructured, open-ended interview questions. Pharmacists who had implemented a CKD screening service in Tasmania, Australia, were eligible to participate. A purposeful sampling strategy was used to select pharmacists, with variation in demographics and pharmacy location. A conventional content analysis approach was used to conduct the qualitative study. Transcripts were thematically analyzed by using the NVivo 11 software program. Initially, a list of free nodes was generated and data were coded exhaustively into relevant nodes. These nodes were then regrouped to form highly conceptualized themes.
Five broad themes emerged from the analysis: contextual fit within community pharmacy; perceived scope of pharmacy practice; customer perception toward disease prevention; CKD - an underestimated disease; and remuneration for a beneficial service. Pharmacists found the CKD service efficient, user-friendly, and of substantial benefit to their customers. However, several pharmacists observed that their customers lacked interest in disease prevention, and had limited understanding of CKD. More importantly, pharmacists perceived the scope of pharmacy practice to depend substantially on interprofessional collaboration between pharmacists and general practitioners, and customer acknowledgment of pharmacists' role in disease prevention.
Community pharmacists perceived the CKD service to be worth incorporating into pharmacy practice. To increase uptake, future CKD services should aim to improve customer awareness about CKD before providing risk assessment. Further research investigating strategies to enhance general practitioner involvement in pharmacist-initiated disease prevention services is also needed.
社区药剂师在提供慢性肾脏病(CKD)筛查服务方面具有得天独厚的优势。然而,对于药剂师在服务实施过程中所面临的挑战,我们知之甚少。本研究旨在探讨社区药剂师实施 CKD 风险评估服务的经验和感知障碍。
采用半结构化、开放式访谈问题进行数据收集。有资格参与研究的是在澳大利亚塔斯马尼亚州实施 CKD 筛查服务的药剂师。采用有目的的抽样策略选择药剂师,其人口统计学和药房位置存在差异。采用常规内容分析方法进行定性研究。使用 NVivo 11 软件程序对转录本进行主题分析。首先,生成一个自由节点列表,并将数据详尽地编码到相关节点中。然后,这些节点被重新分组,形成高度概念化的主题。
分析得出了五个广泛的主题:社区药房内的背景契合度;药店实践的感知范围;顾客对疾病预防的看法;CKD-被低估的疾病;以及有益服务的报酬。药剂师发现 CKD 服务高效、用户友好,对顾客有很大的益处。然而,一些药剂师观察到他们的顾客对疾病预防缺乏兴趣,对 CKD 的了解有限。更重要的是,药剂师认为药店实践的范围在很大程度上取决于药剂师和全科医生之间的跨专业合作,以及顾客对药剂师在疾病预防中的作用的认可。
社区药剂师认为 CKD 服务值得纳入药房实践。为了提高参与度,未来的 CKD 服务应在提供风险评估之前,旨在提高顾客对 CKD 的认识。还需要进一步研究调查策略,以加强全科医生对药剂师发起的疾病预防服务的参与。