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社区药剂师关于局部用皮质类固醇药物咨询的知识、认知及实践:韩国一项真实世界横断面调查与焦点小组讨论

Community pharmacists' knowledge, perceptions, and practices about topical corticosteroid counseling: A real-world cross-sectional survey and focus group discussions in Korea.

作者信息

Kang Min Jung, Park Ji Hyun, Park Sunny, Kim Nam Gyu, Kim Eun Young, Yu Yun Mi, Kim Do Young, Lee Ju-Yeun, Shin Wan Gyoon, Choi Soo An

机构信息

Department of Pharmacy and Biomedical Research Institute Clinical Trials Center, Seoul National University Hospital, Seoul, South Korea.

College of Pharmacy, Korea University, Sejong, South Korea.

出版信息

PLoS One. 2020 Jul 29;15(7):e0236797. doi: 10.1371/journal.pone.0236797. eCollection 2020.

Abstract

Topical corticosteroids (TCs) are widely used to treat dermatological conditions such as eczema and psoriasis. It can be a safe and effective treatment when used appropriately. However, misguided information and corticosteroid phobia appear to contribute to inadequate adherence to therapy, leading to unsatisfactory treatment outcomes. Therefore, community pharmacists (CPs) are in a prime position to inform patients about the appropriate use of medicine. The aim of this study was to examine how the knowledge and perceptions of CPs, as well as other factors, associate CPs' patient counseling practice around the use of TCs. A structured, validated questionnaire was distributed to CPs in the Republic of Korea, and additional focus group discussions were implemented to obtain a deeper understanding of the survey findings. We analyzed the survey results by applying a modified knowledge-perception-practice model. In addition, we used path analysis to validate the model and assessed how knowledge level and perceptions of barriers affect CPs' counseling behavior. We ran a multiple regression to identify factors that associate CPs' practice levels. A total of 1018 surveys were analyzed. In general, respondents had sufficient knowledge to provide appropriate patient counseling on TC use. An increase in knowledge level positively associated the quality of practice, and more knowledge increased the perception of barriers that negatively associated patient counseling. Location in rural areas and pharmacists' perception of counseling barriers negatively associated the quality of practice. A higher level of knowledge, training in ADEs, higher proportion of OTC TC sales, and increased time for counseling positively associated the quality of practice. Therefore, minimizing barriers such as negative perceptions is very important in facilitating CPs' counseling practice around TC use.

摘要

外用糖皮质激素(TCs)被广泛用于治疗湿疹和银屑病等皮肤病。如果使用得当,它可以是一种安全有效的治疗方法。然而,误导性信息和糖皮质激素恐惧症似乎导致了治疗依从性不足,从而导致治疗效果不尽人意。因此,社区药剂师(CPs)处于向患者宣传正确用药方法的有利位置。本研究的目的是探讨CPs的知识和认知以及其他因素如何与CPs围绕TCs使用的患者咨询实践相关联。向韩国的CPs发放了一份经过结构化验证的问卷,并开展了额外的焦点小组讨论,以更深入地理解调查结果。我们应用改进后的知识-认知-实践模型分析了调查结果。此外,我们使用路径分析来验证该模型,并评估知识水平和对障碍的认知如何影响CPs的咨询行为。我们进行了多元回归分析,以确定与CPs实践水平相关的因素。共分析了1018份调查问卷。总体而言,受访者具备足够的知识,能够就TCs的使用为患者提供适当的咨询。知识水平的提高与实践质量呈正相关,知识的增加会增强对障碍的认知,而障碍认知与患者咨询呈负相关。农村地区的地理位置以及药剂师对咨询障碍的认知与实践质量呈负相关。更高的知识水平、药品不良反应培训、非处方TCs销售比例的提高以及咨询时间的增加与实践质量呈正相关。因此,在促进CPs围绕TCs使用的咨询实践中,尽量减少负面认知等障碍非常重要。

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