Buss Vera H, Shield Alison, Kosari Sam, Peterson Gregory M, Naunton Mark
Centre for Primary Health Care and Equity, University of New South Wales, Randwick, Australia.
Faculty of Health, University of Canberra, Bruce, Australia.
Int J Clin Pharm. 2020 Dec;42(6):1385-1395. doi: 10.1007/s11096-020-01102-4. Epub 2020 Aug 16.
Background MedsCheck is an in-pharmacy medication review program funded by the Australian Government. It is intended to improve patient understanding of medicines and resolve adherence issues. Objective To explore MedsCheck from the community pharmacists' perspective, focusing on the perceived effectiveness of the program, barriers to its optimal delivery, and the integration with other services. Setting Individual interviews in one territory and a national online survey of Australian community pharmacists. Method Using a mixed-method triangulation design, the interviews and the survey were conducted concurrently. The interviews were semi-structured, transcribed verbatim and thematically analysed. The survey, comprising closed and open-ended questions, was quantitatively and thematically analysed. The findings were first analysed separately and finally integrated by searching for convergence, complementarity, and discrepancy. Main outcome measure Pharmacists' perceptions of the effectiveness and barriers of MedsCheck. Results Eight interviews were conducted, and 232 survey responses collected. In the interviews, themes related to perceived benefits (appreciation, reduced confusion, and strengthening relationships), barriers (lack of controls, lack of staff, lack of awareness, and lack of understanding of scope of services), and the integration with other services (strong link with dose administration aids) emerged, which mostly correlated with the survey's results. Ten percent of surveyed respondents did not provide the MedsCheck service; their main reason being insufficient staffing. Of the pharmacists offering the service, 76% strongly agreed that patients were benefitting. MedsCheck reviews were usually initiated by pharmacy staff. Fifty-three percent of respondent pharmacists never or only sometimes reported the review outcomes to the patient's general practitioner. Conclusion The pharmacists believed that MedsCheck is useful to improve patients' understanding and management of their medicines. However, there are currently barriers to the effective delivery of the service, including workload issues, lack of patient awareness, and the service's integration with the broader care of the patient. If these were appropriately addressed, the in-pharmacy medication review program could help pharmacists to better engage with patients and general practitioners and enhance understanding of medication and adherence.
背景
药物检查（MedsCheck）是一项由澳大利亚政府资助的药房内药物审查计划。其目的是提高患者对药物的理解并解决用药依从性问题。
目的
从社区药剂师的角度探讨药物检查计划，重点关注该计划的感知效果、最佳实施的障碍以及与其他服务的整合。
设置
在一个地区进行个人访谈，并对澳大利亚社区药剂师进行全国性在线调查。
方法
采用混合方法三角测量设计，访谈和调查同时进行。访谈采用半结构化形式，逐字转录并进行主题分析。该调查包括封闭式和开放式问题，进行了定量和主题分析。研究结果首先分别进行分析，最后通过寻找趋同点、互补点和差异点进行整合。
主要结局指标
药剂师对药物检查计划的有效性和障碍的看法。
结果
进行了8次访谈，收集到232份调查回复。在访谈中，出现了与感知益处（感激、减少困惑以及加强关系）、障碍（缺乏控制、人员不足、缺乏认识以及对服务范围缺乏了解）以及与其他服务的整合（与剂量给药辅助工具的紧密联系）相关的主题，这些主题大多与调查结果相关。10%的受访受访者未提供药物检查服务；其主要原因是人员不足。在提供该服务的药剂师中，76%强烈同意患者从中受益。药物检查审查通常由药房工作人员发起。53%的受访药剂师从未或仅有时向患者的全科医生报告审查结果。
结论
药剂师认为药物检查计划有助于提高患者对其药物的理解和管理。然而，目前该服务的有效实施存在障碍，包括工作量问题、患者缺乏认识以及该服务与患者更广泛护理的整合。如果这些问题得到妥善解决，药房内药物审查计划可以帮助药剂师更好地与患者和全科医生互动，并增强对药物和用药依从性的理解。
