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预防和管理尿路感染:强化社区药剂师的作用——一项混合方法研究

Preventing and Managing Urinary Tract Infections: Enhancing the Role of Community Pharmacists-A Mixed Methods Study.

作者信息

Peiffer-Smadja Nathan, Allison Rosalie, Jones Leah F, Holmes Alison, Patel Parvesh, Lecky Donna M, Ahmad Raheelah, McNulty Cliodna A M

机构信息

National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Faculty of Medicine, Imperial College London, The Hammersmith Hospital, Commonwealth Building, Du Cane Road, London W12 0NN, UK.

IAME, Université de Paris, INSERM, F-75018 Paris, France.

出版信息

Antibiotics (Basel). 2020 Sep 7;9(9):583. doi: 10.3390/antibiotics9090583.

Abstract

BACKGROUND

Community pharmacists are involved in antimicrobial stewardship through self-care advice and delivering medications for uncomplicated infections.

OBJECTIVES

This mixed methods study aimed to identify opportunities to enhance the role of community pharmacists in the management of service users with suspected or confirmed urinary tract infection (UTI).

METHODS

Data collection was through a service user survey (n = 51) and pharmacist surveys and semi-structured interviews before (16 interviews, 22 questionnaires) and after (15 interviews, 16 questionnaires) trialing UTI leaflets designed to be shared with service users. Data were analysed inductively using thematic analysis and descriptive tabulation of quantitative data.

RESULTS

Twenty-five percent (n = 13/51) of service users with urinary symptoms sought help from a pharmacist first and 65% (n = 33/51) were comfortable discussing their urinary symptoms with a pharmacist in a private space. Community pharmacists were confident as the first professional contact for service users with uncomplicated UTI (n = 13/16, 81%), but indicated the lack of a specific patient referral pathway (n = 16/16, 100%), the need for additional funding and staff (n = 10/16, 62%), and the importance of developing prescription options for pharmacists (5/16, 31%). All community pharmacists reported playing a daily role in controlling antimicrobial resistance by educating service users about viral and bacterial infections and promoting a healthy lifestyle. Enhancing their role will need greater integrated working with general practices and more prescribers based in community pharmacy.

CONCLUSION

This study suggests that community pharmacists could play a greater role in the management of uncomplicated UTI. The current reconfiguration of primary care in England with primary care networks and integrated care systems could provide a real opportunity for this collaborative working with potential learning for international initiatives.

摘要

背景

社区药剂师通过提供自我护理建议和为非复杂性感染配药参与抗菌药物管理。

目的

这项混合方法研究旨在确定增强社区药剂师在疑似或确诊尿路感染(UTI)服务使用者管理中作用的机会。

方法

数据收集通过服务使用者调查(n = 51)以及药剂师调查和半结构化访谈进行,在试用旨在与服务使用者分享的UTI宣传册之前(16次访谈,22份问卷)和之后(15次访谈,16份问卷)。数据采用主题分析进行归纳分析,并对定量数据进行描述性制表。

结果

有泌尿症状的服务使用者中,25%(n = 13/51)首先向药剂师寻求帮助,65%(n = 33/51)愿意在私密空间与药剂师讨论他们的泌尿症状。社区药剂师对作为非复杂性UTI服务使用者的首个专业联系人充满信心(n = 13/16,81%),但表示缺乏特定的患者转诊途径(n = 16/16,100%),需要额外资金和人员(n = 10/16,62%),以及为药剂师开发处方选项的重要性(5/16,31%)。所有社区药剂师都报告称,通过向服务使用者宣传病毒和细菌感染知识以及推广健康生活方式,在日常控制抗菌药物耐药性方面发挥作用。增强他们的作用将需要与全科医疗更紧密合作,并在社区药房配备更多开处方者。

结论

本研究表明,社区药剂师在非复杂性UTI的管理中可以发挥更大作用。英国当前通过初级保健网络和综合护理系统对初级保健进行的重新配置,可能为这种合作提供真正机会,并为国际倡议提供潜在借鉴。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c13d/7559416/fc97cf49cc5e/antibiotics-09-00583-g001.jpg

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