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药剂师在社区药房哮喘服务试验中招募患者的经验与观点。

Pharmacists experience of and perspectives about recruiting patients into a community pharmacy asthma service trial.

作者信息

Bertilsson Emma, Serhal Sarah, Emmerton Lynne, Bosnic-Anticevich Sinthia, Krass Ines, Bereznicki Bonnie, Bereznicki Luke, Armour Carol, Saini Bandana

机构信息

Uppsala University - Box 256, 751 05, Uppsala, Sweden.

Woolcock Institute of Medical Research - 431 Glebe Point Road, Glebe, NSW, 2031, Australia.

出版信息

Res Social Adm Pharm. 2021 Mar;17(3):595-605. doi: 10.1016/j.sapharm.2020.05.012. Epub 2020 May 16.

Abstract

BACKGROUND

Research trials testing the impact of community pharmacy services require adequate and appropriate recruitment of patients by participating pharmacists, however, this step presents an ongoing challenge.

OBJECTIVE

To identify factors affecting recruitment of patients in community pharmacies participating in a multi-center trial of a pharmacy asthma service in Australia (Pharmacy Trial Program - Asthma and Rhinitis Control (PTP-ARC).

METHODS

The PTP-ARC protocol required identification and recruitment of seven eligible asthma patients per pharmacy. Pharmacists responsible for sites that failed to recruit or retain any patients into the PTP-ARC trial participated in a semi-structured telephone interview about their experiences with these elements of the trial. The interviews were recorded, transcribed and coded using QSR International's NVivo 11 software. The analysis was conducted with reference to the COM-B framework (Capability, Opportunity, Motivation).

RESULTS

Pharmacists from 47 of 50 eligible pharmacies were interviewed. Seventeen factors were isolated and mapped to the COM-B framework. Psychological capability (recruitment hesitancy, research literacy and health literacy), physical capability (technological barriers, staffing issues and pharmacy busyness), physical opportunity (patient busyness, trial timing, study protocol, support and location), social opportunity (health literacy and supportive milieu), reflective motivation (incentive for participation, simplification) and automatic motivation (patient attitudes and pharmacist-felt experience) were factors affecting pharmacists' participation. Challenges identified included: issues with the software, unfamiliarity with research procedures generally (and specifically with the PTP-ARC protocols), the patients' lack of interest and pharmacists' lack of time.

CONCLUSIONS

To the best of our knowledge, this is the first study to focus on issues affecting patient recruitment into a pharmacy health services (asthma) trial in real time. To propel evidence-based trials towards practice implementation, user-friendly software, pharmacists' training on research and patient-engagement and adequate remuneration to address pharmacist time issues need to be key foci for health services design and implementation research.

摘要

背景

测试社区药房服务影响的研究试验要求参与的药剂师充分且适当地招募患者,然而,这一步骤一直是一项挑战。

目的

确定影响澳大利亚社区药房参与药房哮喘服务多中心试验(药房试验项目 - 哮喘与鼻炎控制(PTP - ARC))患者招募的因素。

方法

PTP - ARC方案要求每个药房识别并招募7名符合条件的哮喘患者。负责未能将任何患者招募或保留到PTP - ARC试验站点的药剂师参与了关于他们在试验这些环节经历的半结构化电话访谈。访谈进行了录音、转录,并使用QSR国际公司的NVivo 11软件进行编码。分析参考COM - B框架(能力、机会、动机)进行。

结果

对50家符合条件的药房中的47家的药剂师进行了访谈。分离出17个因素并映射到COM - B框架。心理能力(招募犹豫、研究素养和健康素养)、身体能力(技术障碍、人员配备问题和药房繁忙程度)、身体机会(患者繁忙程度、试验时间、研究方案、支持和地点)、社会机会(健康素养和支持性环境)、反思性动机(参与激励、简化)和自动性动机(患者态度和药剂师感受的体验)是影响药剂师参与的因素。确定的挑战包括:软件问题、普遍不熟悉研究程序(特别是PTP - ARC方案)、患者缺乏兴趣和药剂师缺乏时间。

结论

据我们所知,这是第一项实时关注影响药房健康服务(哮喘)试验患者招募问题的研究。为推动基于证据的试验向实践实施发展,用户友好的软件、药剂师的研究和患者参与培训以及解决药剂师时间问题的适当报酬需要成为健康服务设计和实施研究的关键重点。

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