Alhossan Abdulaziz, Alazba Asma
Department of Clinical Pharmacy, King Saud University, Riyadh, Saudi Arabia.
Saudi Pharm J. 2019 Jul;27(5):713-716. doi: 10.1016/j.jsps.2019.04.006. Epub 2019 Apr 2.
The current level of awareness among health care providers towards working under collaborative agreements, and the barriers that interfere with establishing CDTM agreements between clinical pharmacists and physicians were studied.
A structured survey was developed after reviewing the literature on CDTM. The questions were validated to assess the level of awareness regarding the role of clinical pharmacists in providing drug therapy management, and to determine the main barriers for not having collaborative agreements with different specialties. In addition to demographic data, physicians' education background, reasons for not having clinical pharmacy services in their clinics, and their perceptions for signing a collaborative agreement were also collected. The sample for the study was obtained from different health specialties in Saudi Arabia. The validated survey was sent and received within approximately two months, Oct-Nov 2017.
We have received 55 responses from different sectors, a 79% response rate. Most physicians had worked before with a clinical pharmacist (76%) and of which 60% valued the services provided by the clinical pharmacist as extremely important and very important (29.1%; 30.9%) respectively. When physicians asked if they have heard about the Collaborative Drug Therapy Management agreement or the term CDTM, 67% of respondents haven't heard that before. Most of the responses, regarding the physicians' awareness of the actual CDTM agreement services, were correct. Only 18% selected incorrect CDTM services. The results showed higher percentages of physicians agreeing with the benefits of CDTM agreement as it can improve overall patient care, reduces risk of drug related adverse events or interactions and allows clinical pharmacists to be part of patient care; 85.5, 83.6 and 83.6 respectively. Physicians who rated the possibility to be involved or to encourage other health care professionals in signing collaborative agreements as high were 76.3 and 74.5 respectively. Based on their specialty, emergency medicine's physicians were most likely to have a CDTM agreement and to encourage others too. On a scale from zero to hundred, the average of the responses rating lack of knowledge about such an agreement as potential barrier on preventing CDTM agreements was 69 ± 0.30. While the gender barrier had the lowest rating with a mean of 15.
There is a huge lack of knowledge and understanding about the role of clinical pharmacists and in CDTM concept. This lack of knowledge affected on having collaborations between clinical pharmacists and physicians in different settings. Educating health care providers and stakeholders about the role of clinical pharmacists in providing drug therapy management and encouraging the concept of CDTM among healthcare providers are the main solutions to enhance clinical pharmacist's role in patient care.
研究医疗保健提供者对根据合作协议开展工作的当前认知水平,以及妨碍临床药剂师与医生之间建立协作药物治疗管理(CDTM)协议的障碍。
在回顾有关CDTM的文献后制定了一份结构化调查问卷。这些问题经过验证,以评估对临床药剂师在提供药物治疗管理方面作用的认知水平,并确定未与不同专业签订合作协议的主要障碍。除人口统计学数据外,还收集了医生的教育背景、其诊所未提供临床药学服务的原因以及他们对签署合作协议的看法。该研究的样本来自沙特阿拉伯的不同医疗专业。经过验证的调查问卷于2017年10月至11月期间在大约两个月内发送并回收。
我们收到了来自不同部门的55份回复,回复率为79%。大多数医生以前曾与临床药剂师合作过(76%),其中60%认为临床药剂师提供的服务极其重要和非常重要(分别为29.1%;30.9%)。当询问医生是否听说过合作药物治疗管理协议或CDTM这个术语时,67%的受访者表示之前没有听说过。关于医生对实际CDTM协议服务的认知,大多数回复是正确的。只有18%选择了错误的CDTM服务。结果显示,更高比例的医生认同CDTM协议的益处,因为它可以改善整体患者护理、降低药物相关不良事件或相互作用的风险,并使临床药剂师能够参与患者护理;认同率分别为85.5%、83.6%和83.6%。认为参与或鼓励其他医疗保健专业人员签署合作协议可能性高的医生比例分别为76.3%和74.5%。根据专业来看,急诊医学医生最有可能拥有CDTM协议并鼓励他人签署。在从0到100的评分中,将对这种协议缺乏了解视为阻碍CDTM协议签订的潜在障碍的回复平均评分为69±0.30。而性别障碍评分最低,平均分为15。
对临床药剂师的作用和CDTM概念存在巨大的知识欠缺和理解不足。这种知识欠缺影响了不同环境下临床药剂师与医生之间的合作。对医疗保健提供者和利益相关者进行关于临床药剂师在提供药物治疗管理方面作用的教育,并在医疗保健提供者中鼓励CDTM概念,是增强临床药剂师在患者护理中作用的主要解决方案。