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开发电子工具(e-AdPharm)以解决社区药剂师在提供药物依从性支持方面的未满足需求和障碍。

Development of an electronic tool (e-AdPharm) to address unmet needs and barriers of community pharmacists to provide medication adherence support to patients.

机构信息

Faculty of Pharmacy, Université de Montréal, Montréal, Québec, Canada; Research Centre, CIUSSS du Nord-de-l'île de Montréal, Montréal, Québec, Canada.

Faculty of Pharmacy, Université Laval, Québec, Québec, Canada; CHU de Québec Research Centre, Population Health and Optimal Health Practices Research Unit, Québec, Québec, Canada.

出版信息

Res Social Adm Pharm. 2021 Mar;17(3):506-513. doi: 10.1016/j.sapharm.2020.04.022. Epub 2020 May 10.

Abstract

BACKGROUND

Community pharmacists are best placed to improve medication adherence because they frequently interact with patients and have been trained to manage medication-related problems. Therefore, it is essential to equip pharmacists adequately to detect non-adherent patients quickly and intervene to improve medication adherence.

OBJECTIVE

To design e-AdPharm, a tool that addresses unmet needs and barriers of community pharmacists to provide medication adherence support to patients with chronic diseases.

METHODS

A qualitative study using 4 focus group discussions with community pharmacists was conducted with a semi-structured interview guide and discussions lasting for 1-2 h. The discussions covered the barriers and needs of pharmacists related to medication adherence support provided to patients, their expectations of an electronic tool based on prescription refills to help them provide this support, and the design of the tool. Focus group data were coded and analyzed using an iterative process, with thematic and descriptive analyses.

RESULTS

Twenty-six community pharmacists participated. Lack of time and motivation from pharmacists and patients were common barriers to the provision of medication adherence support. Accordingly, community pharmacists wished to measure medication adherence quickly, provide easily interpretable data to patients on their medication use, and raise the patient's awareness of non-adherence. The pharmacists expressed their need to have an electronic tool to share medication adherence information with the treating physician. Regarding the design of e-AdPharm, the pharmacists wanted a table displaying medication adherence with a color code representing adherence level. They also stressed the importance of a structured section enabling them to continuously document the interventions made and the need for patient follow-ups.

CONCLUSIONS

e-AdPharm meet the needs and overcome the barriers of community pharmacists to provide medication adherence support to their patients. Future studies should examine the feasibility of implementing e-AdPharm in community pharmacies and test its efficacy for improving medication adherence.

摘要

背景

社区药剂师最适合提高药物依从性,因为他们经常与患者互动,并接受过管理与药物相关问题的培训。因此,充分装备药剂师以快速发现不依从的患者并进行干预以提高药物依从性是至关重要的。

目的

设计电子药物依从性支持工具(e-AdPharm),以满足社区药剂师在为慢性病患者提供药物依从性支持方面的未满足需求和障碍。

方法

采用 4 次焦点小组讨论的定性研究,使用半结构式访谈指南,讨论持续 1-2 小时。讨论涵盖了药剂师在为患者提供药物依从性支持方面的障碍和需求、他们对基于处方续配的电子工具的期望,以及该工具的设计。使用迭代过程对焦点小组数据进行编码和分析,采用主题和描述性分析。

结果

26 名社区药剂师参与了研究。药剂师和患者缺乏时间和动力是提供药物依从性支持的常见障碍。因此,社区药剂师希望快速测量药物依从性,向患者提供其用药情况的易于理解的数据,并提高患者对不依从的认识。药剂师表示需要一种电子工具来与主治医生共享药物依从性信息。关于 e-AdPharm 的设计,药剂师希望有一个显示药物依从性的表格,用颜色代码表示依从水平。他们还强调了有一个能够使他们持续记录所做干预和患者随访需求的结构化部分的重要性。

结论

e-AdPharm 满足了社区药剂师为其患者提供药物依从性支持的需求并克服了相关障碍。未来的研究应检验在社区药房实施 e-AdPharm 的可行性,并测试其提高药物依从性的效果。

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