Hansen Christina Raae, Byrne Stephen, O'Mahony Denis, Kearney Patricia M, Sahm Laura J
Pharmaceutical Care Research Group, School of Pharmacy, Cavanagh Pharmacy Building Room UG06, University College Cork, College Road Cork, Cork, Ireland.
Section for Social and Clinical Pharmacy, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, 2100, Copenhagen Ø, Denmark.
Eur J Clin Pharmacol. 2019 Feb;75(2):265-274. doi: 10.1007/s00228-018-2578-2. Epub 2018 Oct 20.
Older people are at risk of potentially inappropriate prescribing (PIP) due to polypharmacy arising from multi-morbidity. Despite available explicit criteria to reduce PIP, it is highly prevalent. Whilst community pharmacists have the required knowledge to help reduce PIP, they are not currently engaged with the problem. This study explores the views of community pharmacists on their potential involvement in reducing PIP and determines the challenges to its implementation.
Semi-structured interviews with pharmacists working in community pharmacies in Ireland. The theoretical domains framework (TDF) was used to develop the topic guide and to analyse the transcripts. Domains of highest relevance for PIP reduction were identified based on their frequency or whether the participants emphasised the impact of constructs within a domain. Local ethical approval was obtained.
Of 18 participants, 12 were female, median age was 30 years (IQR, 27-35) with a median of 6 years (IQR, 3-8) of experience. Seven TDF domains were identified as relevant to PIP reduction. Pharmacists were uncertain about their role in reducing PIP and reluctant to challenge physicians' prescribing decisions. Challenges pertained to the environment, knowledge, social influences, professional role and identity.
Pharmacists welcomed new responsibilities in reducing PIP as part of their daily practice but expressed a need for removal of social and environmental barriers as well as, provision of relevant guidelines and education about PIP. This study provides useful insights into the target domains for overcoming barriers of pharmacist involvement in reducing PIP.
由于多种疾病导致的多重用药，老年人存在潜在不适当用药（PIP）的风险。尽管有明确的标准来减少PIP，但它仍然非常普遍。虽然社区药剂师具备帮助减少PIP所需的知识，但他们目前并未参与解决这一问题。本研究探讨了社区药剂师对其在减少PIP方面潜在参与度的看法，并确定了实施过程中的挑战。
对爱尔兰社区药房工作的药剂师进行半结构化访谈。理论领域框架（TDF）用于制定主题指南并分析访谈记录。根据其出现频率或参与者是否强调某个领域内概念的影响，确定与减少PIP最相关的领域。获得了当地伦理批准。
18名参与者中，12名女性，年龄中位数为30岁（四分位间距，27 - 35岁），工作经验中位数为6年（四分位间距，3 - 8年）。确定了7个与减少PIP相关的TDF领域。药剂师对其在减少PIP中的作用不确定，并且不愿挑战医生的处方决定。挑战涉及环境、知识、社会影响、专业角色和身份认同。
药剂师欢迎将减少PIP作为日常工作的新职责，但表示需要消除社会和环境障碍，并提供有关PIP的相关指南和教育。本研究为克服药剂师参与减少PIP的障碍的目标领域提供了有用的见解。
