Ahmed Anan, Blackburn David F, Evans Charity, Rosaasen Nicola, Mansell Holly
College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada.
Saskatchewan Transplant Program, Saskatchewan Health Authority, Saskatoon, Canada.
Can J Kidney Health Dis. 2020 Oct 22;7:2054358120954028. doi: 10.1177/2054358120954028. eCollection 2020.
The Saskatchewan Medication Assessment Program (SMAP) compensates community pharmacists for medication reviews on eligible residents with the goal of optimizing patient care. Although medication reviews are meant to reduce risks associated with complex medication regimens, some patients may already be receiving specialized care from interdisciplinary health care teams from the renal programs in Saskatchewan.
A qualitative analysis was undertaken to examine the perceptions of health care providers about the SMAP process for patients receiving renal care in Saskatchewan. The goal was to explore potential benefits, facilitators, challenges, and/or barriers of the program in this population.
Qualitative descriptive study.
The semi-structured interviews took place in the province of Saskatchewan.
Community pharmacists, renal pharmacist, and nephrologists.
All nephrologists, renal pharmacists, and community pharmacies in Saskatoon and Regina were sent an invitation to participate in the study. Semi-structured interviews were completed with participants and were audio-recorded and transcribed verbatim. Coding was performed using NVIVO qualitative software, and meaning units and codes were consolidated into categories and subcategories using qualitative content analysis.
A total of 9 community pharmacists, 10 renal pharmacists, and 8 nephrologists were interviewed. Community pharmacists had mixed levels of comfort providing SMAP assessments for renal patients, but expressed the desire to provide the best care possible and described patient benefits. Some categories (eg, barriers and improvements) and subcategories (eg, "collaboration/communication", "other challenges," and "suggestions for improvement") were consistent among all participant groups, while others (eg, "renal patients have complex care needs" and "duplication of service") were common among both renal pharmacists and nephrologists. The nephrologists had little knowledge of the program and of the role of the community pharmacist, indicating the need for improved education and communication.
The lack of renal patient perceptions on the SMAP process should be acknowledged and studied in future. A further limitation is the small sample size per subsample group.
Despite some negative experiences, all of the participants believed the program can be beneficial. However, several recommendations were suggested to improve the SMAP process in renal patients and other complex patient populations.
萨斯喀彻温省药物评估项目（SMAP）为社区药剂师对符合条件的居民进行药物审查提供补偿，目的是优化患者护理。尽管药物审查旨在降低与复杂药物治疗方案相关的风险，但一些患者可能已经在接受萨斯喀彻温省肾脏项目跨学科医疗团队的专科护理。
进行定性分析，以研究医疗服务提供者对萨斯喀彻温省接受肾脏护理患者的SMAP流程的看法。目标是探索该项目在这一人群中的潜在益处、促进因素、挑战和/或障碍。
定性描述性研究。
半结构化访谈在萨斯喀彻温省进行。
社区药剂师、肾脏药剂师和肾病学家。
向萨斯卡通和里贾纳的所有肾病学家、肾脏药剂师和社区药房发出参与研究的邀请。与参与者完成半结构化访谈，并进行录音和逐字转录。使用NVIVO定性软件进行编码，并使用定性内容分析将意义单元和代码合并为类别和子类别。
共访谈了9名社区药剂师、10名肾脏药剂师和8名肾病学家。社区药剂师为肾病患者提供SMAP评估时的舒适度参差不齐，但表示希望提供尽可能好的护理并描述了患者的益处。一些类别（如障碍和改进）和子类别（如“协作/沟通”、“其他挑战”和“改进建议”）在所有参与者组中是一致的，而其他一些（如“肾病患者有复杂的护理需求”和“服务重复”）在肾脏药剂师和肾病学家中都很常见。肾病学家对该项目和社区药剂师的角色了解甚少，表明需要加强教育和沟通。
应认识到并在未来研究缺乏肾病患者对SMAP流程的看法。另一个局限性是每个子样本组的样本量较小。
尽管有一些负面经历，但所有参与者都认为该项目可能有益。然而，有人提出了一些建议，以改进针对肾病患者和其他复杂患者群体的SMAP流程。
