Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
National University Centre for Oral Health, National University of Singapore, Singapore, Singapore.
BMJ Open. 2020 Feb 28;10(2):e032261. doi: 10.1136/bmjopen-2019-032261.
To explore the attitudes towards, and perceptions of, primary care healthcare staff and patients, regarding the role of clinical pharmacists in the provision of oral health advice and collaboration with dentists in general practice.
Interpretivist methodology using qualitative semi-structured interviews and focus groups.
22 participants; 10 pharmacists; 3 general practitioners; 2 nurses; 1 practice manager; 6 patients.
Primary care general medical practices in the North East of England and the University of Sunderland Patient Carer and Public Involvement group.
One-to-one semi-structured interviews were performed with primary care healthcare staff. An iterative approach using constant comparative analysis facilitated the ongoing enrichment of data; salient themes were identified using Framework Analysis and related back to extant literature. A focus group was held with patients to further explore key themes.
Four salient and inter-related themes emerged: enhanced clinical roles; indicating rapidly changing roles of pharmacists working in general practice, increased responsibility and accountability of pharmacist prescribers and the delivery of advanced clinical services; limited knowledge; indicating basic understanding of appropriate oral health advice, but limited insight and provision of advice to patients with regards to links with systemic diseases and medication; geographical/situational isolation of the dental team; indicating the disparate contexts and challenges of multidisciplinary working in oral health, and patients' attitudes towards dental care; integration of oral health advice; indicating the potential of pharmacists to integrate oral health advice into current roles and to target specific patient groups in practice.
The lack of integration between oral and general healthcare services potentially impacts negatively on patient care, requiring further interprofessional oral health education. The developing role of the pharmacist in general practice represents an opportunity to integrate oral health advice and/or interventions into the management of patients in this setting.
探讨初级保健医护人员和患者对临床药师在提供口腔健康建议以及与全科牙医合作方面的角色的态度和看法。
采用解释主义方法，使用定性半结构式访谈和焦点小组。
22 名参与者；10 名药剂师；3 名全科医生；2 名护士；1 名诊所经理；6 名患者。
英格兰东北部的初级保健全科医疗实践和桑德兰大学患者护理和公众参与小组。
对初级保健医护人员进行一对一的半结构式访谈。采用不断比较分析的迭代方法，丰富数据；使用框架分析确定突出主题，并与现有文献相关联。与患者举行焦点小组，进一步探讨关键主题。
出现了四个突出且相互关联的主题：增强的临床角色；表明在全科医疗中工作的药剂师的角色迅速变化，药剂师处方者的责任和问责制增加，以及提供高级临床服务；知识有限；表明对适当口腔健康建议有基本的了解，但对与系统性疾病和药物相关的建议以及向患者提供建议的了解有限；牙科团队的地理位置/情境隔离；表明口腔健康多学科工作的背景和挑战不同，以及患者对牙科护理的态度；口腔健康建议的整合；表明药剂师有可能将口腔健康建议整合到当前的角色中，并在实践中针对特定的患者群体。
口腔和一般医疗保健服务之间缺乏整合，可能对患者护理产生负面影响，需要进一步进行跨专业的口腔健康教育。药剂师在全科医疗中的角色不断发展，代表了将口腔健康建议和/或干预措施整合到该环境中患者管理中的机会。
