J Am Pharm Assoc (2003). 2020 Jul-Aug;60(4):548-558. doi: 10.1016/j.japh.2020.01.007. Epub 2020 Mar 12.
Patients undergoing antidepressant drug treatment (ADT) may face challenges regarding its adverse effects, adherence, and efficacy. Community pharmacists are well positioned to manage ADT-related problems. Little is known about the factors influencing pharmacists' ADT monitoring. This study aimed to identify the psychosocial factors associated with pharmacists' intention to perform systematic ADT monitoring and report on this monitoring.
Cross-sectional study based on the Theory of Planned Behavior (TPB).
Community pharmacists in the province of Quebec, Canada.
Pharmacists completed a questionnaire on their performance of ADT monitoring, TPB constructs (intention; attitude; subjective norm; perceived behavioral control; and attitudinal, normative, and control beliefs), and professional identity. Systematic ADT monitoring was defined as pharmacists' reporting 4 or more consultations with each patient during the first year of ADT to address adverse effects, adherence, and efficacy. Hierarchical linear regression models were used to identify the factors associated with the intention and reporting of systematic ADT monitoring and Poisson working models to identify the beliefs associated with intention.
A total of 1609 pharmacists completed the questionnaire (participation = 29.6%). Systematic ADT monitoring was not widely reported (mean score = 2.0 out of 5.0), and intention was moderate (mean = 3.2). Pharmacists' intention was the sole psychosocial factor associated with reporting systematic ADT monitoring (P < 0.0001; R = 0.370). All TPB constructs and professional identity were associated with intention (P < 0.0001; R = 0.611). Perceived behavioral control had the strongest association.
Interventions to promote systematic ADT monitoring should focus on developing a strong intention among pharmacists, which could, in turn, influence their practice. To influence intention, priority should be given to ensuring that pharmacists feel capable of performing this monitoring. The main barriers to overcome were the presence of only 1 pharmacist at work and limited time. Other factors identified offer complementary intervention targets.
接受抗抑郁药物治疗（ADT）的患者可能会面临药物不良反应、依从性和疗效方面的挑战。社区药剂师非常适合处理 ADT 相关问题。但是，对于影响药剂师 ADT 监测意愿的因素知之甚少。本研究旨在确定与药剂师进行系统 ADT 监测意愿相关的心理社会因素，并报告监测情况。
基于计划行为理论（TPB）的横断面研究。
加拿大魁北克省的社区药剂师。
药剂师完成了一份关于他们进行 ADT 监测的问卷，包括 TPB 构念（意愿；态度；主观规范；感知行为控制；以及态度、规范和控制信念）和专业身份。系统 ADT 监测被定义为药剂师在 ADT 的第一年中报告与每个患者进行 4 次或更多次咨询，以解决不良反应、依从性和疗效问题。采用分层线性回归模型确定与监测意愿和报告相关的因素，并采用泊松工作模型确定与意愿相关的信念。
共有 1609 名药剂师完成了问卷（参与率=29.6%）。系统 ADT 监测的报告并不广泛（平均得分为 5.0 分中的 2.0 分），意愿处于中等水平（平均 3.2 分）。药剂师的意愿是与报告系统 ADT 监测唯一相关的心理社会因素（P<0.0001；R=0.370）。所有 TPB 构念和专业身份都与意愿相关（P<0.0001；R=0.611）。感知行为控制的关联最强。
促进系统 ADT 监测的干预措施应侧重于培养药剂师的强烈意愿，这反过来又会影响他们的实践。为了影响意愿，应优先确保药剂师感到有能力进行这种监测。需要克服的主要障碍是工作场所只有 1 名药剂师和时间有限。确定的其他因素提供了补充的干预目标。
