J Am Pharm Assoc (2003). 2019 Nov-Dec;59(6):852-856. doi: 10.1016/j.japh.2019.08.001. Epub 2019 Sep 6.
This study used an innovative information-gathering approach to provide insight into the nature and structure of pharmacy staff encounters with patients seeking over-the-counter (OTC) medications and revealed specific activities of pharmacy staff around these encounters.
A multistep process was used to develop and standardize an 8-item OTC Encounter Form to document the characteristics of pharmacy staff-patient encounters. The OTC Form contained several domains, including topics discussed and the problems or symptoms identified during the encounter, staff functions during the encounter, and approximate time spent with the patient. Nine pharmacists and 8 technicians used the OTC Form to document patient encounters over 7 consecutive days. Frequency distributions for each OTC Form item are reported.
One hundred eleven OTC Forms were completed. Adults aged 65 years or older were involved in 46% of all encounters. Pharmacists provided the only assistance in 41% of encounters and worked in partnership with other pharmacy staff for another 25% of encounters. Many encounters required the pharmacy staff to leave the prescription department, involved discussions about a variety of problems or symptoms, and lasted less than 3 minutes. Although the most prevalent encounter topic was locations of a particular product, about one-third of encounters involved either recommendations about a product or providing information about a product, and 41% involved communications about 2 or more topics. Finally, 11% of encounters generated a nondrug recommendation, and 8% resulted in a referral to a physician.
Pharmacists play a key role in ensuring that the benefits of OTC medications outweigh the risks, thereby providing an important resource for patient engagement about safe medication selection and use. Examining the features of OTC encounters creates an evidence base to promote best practices for OTC encounters, increasing pharmacists' ability to help people, especially older adults, navigate the intricacies of OTC medication use, without significantly increasing pharmacy staff workload.
本研究采用创新的信息收集方法,深入了解药剂师与寻求非处方 (OTC) 药物的患者之间的互动性质和结构,并揭示了药剂师在这些互动过程中的具体活动。
采用多步流程开发并标准化了一个包含 8 项内容的 OTC 互动表单,以记录药剂师-患者互动的特征。OTC 表单包含多个领域,包括互动中讨论的主题以及识别出的问题或症状、互动期间的工作人员职能以及与患者相处的大致时间。9 名药剂师和 8 名技术员使用 OTC 表单在连续 7 天内记录患者的互动情况。报告了每个 OTC 表单项目的频率分布。
共完成了 111 份 OTC 表单。在所有互动中,65 岁或以上的成年人占 46%。药剂师在 41%的互动中提供了唯一的帮助,在另外 25%的互动中与其他药剂师工作人员合作。许多互动需要药剂师离开配药部门,涉及各种问题或症状的讨论,且持续时间不到 3 分钟。虽然最常见的互动主题是特定产品的位置,但约三分之一的互动涉及产品的推荐或产品信息的提供,41%的互动涉及 2 个或更多主题的沟通。最后,11%的互动产生了非药物推荐,8%导致转介给医生。
药剂师在确保 OTC 药物的益处大于风险方面发挥着关键作用,从而为患者安全选择和使用药物提供了重要资源。研究 OTC 互动的特征为促进 OTC 互动的最佳实践创建了证据基础,提高了药剂师帮助人们(尤其是老年人)驾驭 OTC 药物使用复杂性的能力,而不会显著增加药剂师的工作量。