Yao Dongning, Hu Hao, Harnett Joanna E, Ung Carolina Oi Lam
State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China.
The University of Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Australia.
Eur J Integr Med. 2020 Feb;34:101063. doi: 10.1016/j.eujim.2020.101063. Epub 2020 Feb 5.
In China, Traditional Chinese Medicine (TCM) is an integral part of the health system in parallel with Western medicine (WM). However, pharmacists' duty of care at this interface has not been fully explored. This qualitative study aimed to explore key stakeholders' perceptions about the challenges and enablers to pharmacists' adopting a professional role in patient care associated with the concurrent use of herbal medicines (HMs).
Participants were recruited from the expert pool of the National Research Center for Licensed Pharmacist Development using purposive sampling and snowballing. Participants targeted included government, academics and practicing pharmacists. An interview guide was developed following a literature review and face-to-face, audiotaped interviews conducted with key stakeholders.
Fourteen semi-structured interviews with both practicing pharmacists and key stakeholder representatives were conducted in China in 2017. Thematic analysis identified 6 main themes which focused on how TCM was integrated with WM in China. Participants agreed that pharmacists should at least assume a role in drug safety associated with concurrent use of TCM and WM. However, barriers were identified within the government, education, pharmacy, pharmacist and research sectors, indicating a lack of coordinated strategies to improve this area of healthcare. A lack of clarity in defining the pharmacists' role in this area and a disconnect between current regulatory standards and education/training system were the prominent themes. Participants looked towards the government to facilitate actions in the development of policies that support pharmacy practice and practice guidelines, and the review of competency standards, and registration criteria as being the most important enablers.
Guiding principles that outline standards for pharmacy practice regarding HMs in an integrated healthcare system are considered a priority, requiring a joint effort from the government, professional organizations and universities.
在中国，传统中医（TCM）是与西医（WM）并行的卫生系统的一个组成部分。然而，药剂师在这一交叉领域的照护职责尚未得到充分探讨。这项定性研究旨在探讨关键利益相关者对药剂师在与草药（HMs）同时使用相关的患者护理中发挥专业作用所面临的挑战和促进因素的看法。
采用目的抽样和滚雪球抽样的方法，从国家执业药师发展研究中心的专家库中招募参与者。目标参与者包括政府人员、学者和执业药剂师。在文献综述之后制定了一份访谈指南，并与关键利益相关者进行了面对面的录音访谈。
2017年在中国对执业药剂师和关键利益相关者代表进行了14次半结构化访谈。主题分析确定了6个主要主题，重点关注中医在中国如何与西医相结合。参与者一致认为，药剂师至少应在与中药和西药同时使用相关的药物安全方面发挥作用。然而，在政府、教育、药房、药剂师和研究部门发现了障碍，表明缺乏协调战略来改善这一医疗保健领域。在界定药剂师在这一领域的作用方面缺乏明确性，以及当前监管标准与教育/培训系统之间的脱节是突出主题。参与者期望政府推动制定支持药房实践和实践指南的政策，以及审查能力标准和注册标准，认为这是最重要的促进因素。
在综合医疗系统中概述草药药房实践标准的指导原则被认为是优先事项，需要政府、专业组织和大学共同努力。
