Al Juffali Lobna Abdullah, Knapp Peter, Al-Aqeel Sinaa, Watson Margaret C
Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
University of York and the Hull York Medical School, York, UK.
BMJ Open. 2019 Nov 5;9(11):e032419. doi: 10.1136/bmjopen-2019-032419.
To achieve multi-stakeholder consensus and prioritisation of medication safety problems in community pharmacies in Saudi Arabia.
A theoretically-underpinned, three-round Delphi study.
Saudi Arabia.
Patients and public (pharmacy users), pharmacy-related professionals (policymakers, academics, medication safety officers and pharmacy owners) and community pharmacists.
Round 1 comprised 84 statements derived from a qualitative study. The items were grouped according to the Human Factors Framework (HFF). Rounds 1 and 2 aimed to achieve consensus, 6-point Likert response scale (agreement/disagreement) was used. Round 3 aimed to prioritise the items for which consensus was achieved in Rounds 1 and 2 indicated on a 5-point scale (very important to unimportant). Consensus was predefined as any item that achieved ≥70%.
The number of respondents in Rounds 1, 2 and 3 was 161, 120 and 112, respectively. In all three rounds, the majority of respondents were pharmacy users (Round 1 77% (n=124), Round 2 74% (n=89), Round 3 72% (n=81)). Consensus was achieved with 28/84 items. The top five medication safety priorities were: lack of pharmacy facilities such as counselling area, lack of communication between pharmacists and physicians, lack of patient databases, lack of post-registration pharmacist education and pharmacists' long working hours. The professional and pharmacy user groups achieved consensus on similar items through different categories of the HFFs. Community pharmacists had the highest percentage of consensus among the three groups for factors related to work, such as high workload and low salaries.
This multi-stakeholder study used the HFF to identify and prioritise the main medication safety challenges facing community pharmacy in Saudi Arabia. It indicates the need for changes to practice and policy and further research to address these priorities and promote medication safety at an individual, pharmacy and population level.
在沙特阿拉伯的社区药房中，达成多利益相关方对用药安全问题的共识并确定其优先级。
一项基于理论的三轮德尔菲研究。
沙特阿拉伯。
患者及公众（药房使用者）、与药房相关的专业人员（政策制定者、学者、用药安全官员及药房所有者）以及社区药剂师。
第一轮包含从定性研究中得出的84条陈述。这些条目根据人为因素框架（HFF）进行分组。第一轮和第二轮旨在达成共识，采用6点李克特量表（同意/不同意）。第三轮旨在对第一轮和第二轮达成共识的条目按5点量表（非常重要到不重要）确定优先级。共识被预先定义为任何达到≥70%的条目。
第一轮、第二轮和第三轮的受访者数量分别为161、120和112。在所有三轮中，大多数受访者是药房使用者（第一轮77%（n = 124），第二轮74%（n = 89），第三轮72%（n = 81））。84条条目中有28条达成了共识。用药安全的前五大优先事项为：缺乏如咨询区等药房设施、药剂师与医生之间缺乏沟通、缺乏患者数据库、缺乏注册后药剂师教育以及药剂师工作时间过长。专业人员和药房使用者群体通过HFF的不同类别在相似条目上达成了共识。在与工作相关的因素（如高工作量和低薪资）方面，社区药剂师在三组中达成共识的百分比最高。
这项多利益相关方研究利用HFF来识别并确定沙特阿拉伯社区药房面临的主要用药安全挑战的优先级。这表明需要改变实践和政策，并进行进一步研究以解决这些优先事项，在个人、药房和人群层面促进用药安全。
