Yande Soham D, Masurkar Prajakta P, Gopinathan Suma, S Sansgiry Sujit
BPharm. Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston. Houston, TX (United States).
MPharm. Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston. Houston, TX (United States).
Pharm Pract (Granada). 2020 Jan-Mar;18(1):1696. doi: 10.18549/PharmPract.2020.1.1696. Epub 2020 Feb 24.
This study evaluated medication counseling procedures and trends at retail pharmacies in the Houston metropolitan area through a naturalistic observational study.
A blinded cross-sectional observational study was conducted at retail pharmacies in the Houston metropolitan area. Data were collected by trained observers utilizing an observational log, to record various parameters that could have an impact on the duration of patient-pharmacist interaction in a naturalistic pharmacy practice setting. Additionally, indicators of counseling such as utilization of the counseling window and performance of show-and-tell were recorded. Statistical analyses included descriptive statistics, t-tests, Pearson correlations, ANOVAs, and multiple linear regressions.
One hundred and sixty-five interactions between patients and pharmacy staff were recorded at 45 retail pharmacies from 7 retail pharmacy chains. The counseling window was utilized in only 3 (1.81%) out of 165 observations and the show-and-tell process was observed in just 1(0.61%) interaction during this study. Mean (SD) interaction time between patient and pharmacists [159.50 (84.50)] was not statistically different (p>0.05) from the mean interaction time between patients and pharmacy technicians [139.30 (74.19)], irrespective of type of the retail chain observed. However, it was influenced by the number of patients waiting in queue. Patient wait time significantly differed by the time of the day the interaction was observed, weekends and weekdays had significantly different wait times and patient interaction times Multiple linear regression analyses indicated that, patient interaction time, pharmacy chain type, initial contact (pharmacist/technician), and time of the day, were significantly associated with patient wait time whereas patient wait time, pharmacy chain type, number of patients in queue, and number of pharmacy technician were significantly associated with interaction time.
Our study found that the key indicators of counseling including the use of the counseling window and the show-and-tell process were absent, suggesting lack of adequate pharmacists counseling. Further studies are needed to evaluate the validity of this conclusion and the role of pharmacy services and its value towards medication use and safety.
本研究通过一项自然观察性研究，评估了休斯顿大都市区零售药店的用药咨询程序及趋势。
在休斯顿大都市区的零售药店开展了一项双盲横断面观察性研究。由经过培训的观察员使用观察日志收集数据，以记录在自然的药店实践环境中可能影响患者与药剂师互动时长的各种参数。此外，还记录了咨询指标，如咨询窗口的使用情况以及演示讲解的执行情况。统计分析包括描述性统计、t检验、Pearson相关性分析、方差分析和多元线性回归。
在来自7家零售连锁药店的45家零售药店中，记录了165次患者与药店工作人员之间的互动。在本研究的165次观察中，仅3次（1.81%）使用了咨询窗口，且仅在1次（0.61%）互动中观察到了演示讲解过程。无论所观察的零售连锁药店类型如何，患者与药剂师之间的平均（标准差）互动时间[159.50（84.50）]与患者与药房技术人员之间的平均互动时间[139.30（74.19）]在统计学上无显著差异（p>0.05）。然而，它受到排队等候患者数量的影响。根据观察互动的时间段不同，患者等待时间存在显著差异，周末和工作日的等待时间及患者互动时间也存在显著差异。多元线性回归分析表明，患者互动时间、连锁药店类型、首次接触人员（药剂师/技术人员）以及时间段与患者等待时间显著相关，而患者等待时间、连锁药店类型、排队患者数量以及药房技术人员数量与互动时间显著相关。
我们的研究发现，包括咨询窗口使用和演示讲解过程在内的咨询关键指标缺失，这表明缺乏充分的药剂师咨询服务。需要进一步研究来评估这一结论的有效性以及药房服务在药物使用和安全方面的作用及其价值。
