Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.
The Woolcock Institute of Medical Research, Glebe, NSW, Australia.
J Asthma. 2021 Dec;58(12):1648-1660. doi: 10.1080/02770903.2020.1823408. Epub 2020 Sep 26.
Asthma affects 2.7 million people in Australia and is predominantly managed by general practitioners (GPs) within primary care. Despite national focus on this condition, asthma control in the population is suboptimal, with many preventable hospitalizations. In the light of robust evidence supporting the role of pharmacists in the management of chronic diseases including asthma, the Australian Medical Association (AMA) proposed a General Practice Pharmacist (GPP) model in 2015. In this proposal, a non-dispensing pharmacist, co-located within the primary care setting and collaborating with GPs and allied health professionals, can make a positive impact on patients' health and minimize costs due to medication misadventure. The aim of this study was to obtain the views of GPs regarding the GPP model for better management of asthma in a qualitative study.
Semi-structured interviews were conducted with 23 GPs, audio-recorded, transcribed verbatim, and later analyzed for emergent themes. The GPs support the idea of a GPP as time and task pressures restrict them in adhering to asthma management guidelines.
Support from another health professional in such a pressured environment can positively impact patient's health. Funding, clear role delineation within general practice, training of pharmacists working as GPPs, and effective communication systems were described as the potential catalysts for the success of the model.
Sustainable funding and the willingness of practice owners/managers were described as the barriers. The GPs agreed that pharmacists can make a positive difference in patient's asthma management once the barriers were effectively addressed.
哮喘影响了澳大利亚的 270 万人,主要由初级保健中的全科医生(GP)管理。尽管国家对这种疾病高度关注,但人群中的哮喘控制仍然不理想,导致许多可预防的住院治疗。鉴于有强有力的证据支持药剂师在包括哮喘在内的慢性病管理中的作用,澳大利亚医学协会(AMA)在 2015 年提出了一般实践药剂师(GPP)模式。在这个方案中,非配药药剂师与全科医生和其他健康专业人员一起,在初级保健环境中共同协作,可以对患者的健康产生积极影响,并最大程度地减少因用药失误而导致的成本。本研究的目的是在定性研究中获得全科医生对 GPP 模式的意见,以更好地管理哮喘。
对 23 名全科医生进行了半结构化访谈,录音、逐字转录,并对出现的主题进行了分析。全科医生支持 GPP 的想法,因为时间和任务压力限制了他们遵守哮喘管理指南的能力。
在这种有压力的环境中,另一位健康专业人员的支持可以对患者的健康产生积极影响。资金、一般实践中明确的角色划分、对作为 GPP 工作的药剂师的培训以及有效的沟通系统被描述为该模式成功的潜在催化剂。
可持续的资金和实践所有者/管理者的意愿被描述为障碍。全科医生一致认为,一旦有效地解决了这些障碍,药剂师就可以在患者的哮喘管理中产生积极的影响。