Handyside Louisa, Warren Robin, Devine Sue, Drovandi Aaron
College of Medicine and Dentistry, James Cook University, Townsville, Australia.
Western Queensland Primary Health Network, Mount Isa, Australia.
Res Social Adm Pharm. 2021 Feb;17(2):292-299. doi: 10.1016/j.sapharm.2020.03.021. Epub 2020 Mar 31.
Health needs assessment tools such as the PRECEDE-PROCEED model (PPM) identify the key health concerns of communities, and may increase the capacity for community pharmacies to address these needs.
A narrative review was conducted to investigate to what extent the PPM has been used to guide pharmacy service development and evaluation.
A systematic search of six databases was conducted for peer-reviewed papers published from January 2000 to August 2019 that described the application of the PPM within the community pharmacy context. Search terms included variations of the following: 'pharmacists', 'precede proceed', 'pharmaceutical services', and 'community pharmacies'. Data extracted and analysed included study design, objectives, population, utilisation of the PPM, and outcomes.
Fourteen eligible papers were identified, most of which were cohort or cross-sectional studies and utilised at least one element of the PPM to design or evaluate interventions that targeted either patient behaviours or pharmacist behaviours, or evaluated population health needs or programs. The range of behaviours assessed was limited to patient medication adherence, and billing behaviours, readiness for expanded scope of practice, and communication for pharmacists. None of the studies prioritised community health needs, actively engaged all relevant stakeholders, or utilised every element of the PPM.
The PPM has been underutilised in community pharmacy research and represents an effective method for the assessment of health priorities for communities and the development and evaluation of health services targeted at addressing these priorities. Further research needs to demonstrate how key health needs assessment principles such as stakeholder engagement and a population-centred approach can influence effective health service delivery.
诸如“健康促进模式”（PPM）等健康需求评估工具可确定社区的关键健康问题，并可能提高社区药房满足这些需求的能力。
进行一项叙述性综述，以调查PPM在多大程度上被用于指导药房服务的开发和评估。
对六个数据库进行系统检索，查找2000年1月至2019年8月发表的同行评审论文，这些论文描述了PPM在社区药房背景下的应用。检索词包括以下内容的变体：“药剂师”、“健康促进模式”、“药学服务”和“社区药房”。提取和分析的数据包括研究设计、目标、人群、PPM的使用情况以及结果。
共识别出14篇符合条件的论文，其中大多数是队列研究或横断面研究，并且利用了PPM的至少一个要素来设计或评估针对患者行为或药剂师行为的干预措施，或评估人群健康需求或项目。所评估的行为范围仅限于患者的用药依从性、计费行为、扩大执业范围的意愿以及药剂师的沟通情况。没有一项研究将社区健康需求作为优先事项，积极让所有相关利益攸关方参与，或利用PPM的每个要素。
PPM在社区药房研究中的利用不足，它是评估社区健康优先事项以及针对这些优先事项开发和评估健康服务的有效方法。进一步的研究需要证明诸如利益攸关方参与和以人群为中心的方法等关键健康需求评估原则如何能够影响有效的健康服务提供。
