School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Australia.
Discipline of Addiction Medicine, Central Clinical School, Sydney Medical School, The University of Sydney, Australia.
Res Social Adm Pharm. 2019 Aug;15(8):966-973. doi: 10.1016/j.sapharm.2019.01.017. Epub 2019 Feb 1.
Prescription opioids (POs) are well recognised for their role in pain management. However over recent years, use of POs has become an increasingly complex public health issue, with the emergence of increasing quantities of POs being misused and abused. Pharmacists represent the 'gatekeepers' of medicines, which can be a challenging role, relating in particular to POs.
This study aimed to gain insight into the challenges Australian community pharmacists experience in the dispensation of POs.
Sydney Australia.
Twenty-five pharmacists were recruited from suburbs in and around Sydney, Australia. Pharmacists were interviewed using an in-depth, semi-structured protocol. All interviews were audio-recorded, transcribed and thematically analysed.
Identification of issues/factors that may influence the dispensing of POs.
Pharmacists were reportedly confronted with several issues in the dispensing of POs, particularly in relation to the patient and prescriber. Pharmacists reported some individuals becoming increasingly more "creative" in the methods used to obtain POs, rendering detection of potential abuse/misuse increasingly difficult. Poor professional relationships with prescribers-an apparent power dynamic between the two professions, and limited engagement with patients were issues also identified. The majority of participants suggested that an electronic monitoring database would help in the identification of PO abuse/misuse.
Education is required to emphasise the importance of inter-professional collaboration between pharmacists and prescribers, as is empathy in the pharmacist-patient relationship. Prescription drug monitoring programs and prescribers sending electronic prescriptions directly to the pharmacist were perceived as helpful initiatives to undertake.
处方类阿片药物（POs）在疼痛管理中作用明确。然而，近年来，PO 的使用已成为一个日益复杂的公共卫生问题，越来越多的 PO 被滥用于医疗目的之外。药剂师是药品的“守门员”，这是一个具有挑战性的角色，尤其是在 PO 方面。
本研究旨在深入了解澳大利亚社区药剂师在分发 PO 时所面临的挑战。
澳大利亚悉尼。
从澳大利亚悉尼及其周边郊区招募了 25 名药剂师。采用深入的半结构式访谈协议对药剂师进行访谈。所有访谈均进行音频录制、转录和主题分析。
识别可能影响 PO 分发的问题/因素。
据报道，药剂师在分发 PO 时面临着几个问题，特别是与患者和处方医生有关。药剂师报告称，一些人在获取 PO 方面变得越来越“有创意”，使得潜在的滥用/误用的检测变得越来越困难。与处方医生的职业关系紧张——这是两个专业之间明显的权力动态，以及与患者的互动有限，也是确定的问题。大多数参与者建议建立电子监测数据库，以帮助识别 PO 的滥用/误用。
需要进行教育，强调药剂师和处方医生之间专业合作的重要性，同时在药剂师-患者关系中培养同理心。处方药物监测计划和处方医生直接向药剂师发送电子处方被认为是有益的举措。
