Hays Catherine, Sparrow Melanie, Taylor Selina, Lindsay Daniel, Glass Beverley
Centre for Rural and Remote Health, James Cook University, Mount Isa, Queensland, Australia.
Pharmacy, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.
J Multidiscip Healthc. 2020 Dec 1;13:1781-1789. doi: 10.2147/JMDH.S279243. eCollection 2020.
Poor health outcomes for patients living in rural and remote areas of Australia are often attributed to the lack of a range of accessible health professionals delivering health services. Community pharmacists are already an integral part of these communities and as such are often the most frequently consulted health professionals. The aim of this study was to explore rural pharmacist knowledge and experiences of expanded pharmacy and to identify the barriers and enablers to remote pharmacists providing expanded pharmacy services (EPS), which can be described as services outside of usual medication management tasks.
Rural and remote pharmacists (Modified Monash Model (MMM) categories 2-7) participated in an online survey. Descriptive statistics and chi-squared tests were performed and data from open-ended questions were analyzed, categorized into themes and quantitized.
Two-thirds (n=13, 68%) of rural pharmacists surveyed (n=19) had knowledge of EPS in rural pharmacies and the majority (n=17, 89%) agreed that these services would benefit rural communities. Mental health service referral was considered very/extremely important by the majority (n=16, 84%) of respondents; however, no pharmacists were currently providing mental health screening services while (n=15, 79%) were willing to provide these services. While staff shortages, costs, time and training were indicated to be the main barriers to the provision of EPS, enablers included accessibility of rural pharmacies and a perceived need.
This study indicated that pharmacists are already providing some EPS and see value in their implementation; however, what constitutes an expanded service was unclear to some participants. Mental health services were highlighted as most important demonstrating a recognized burden of mental illness in rural and remote locations. Findings from this pilot study will provide further understanding for future development of the pharmacist's scope of practice and implementation of EPS.
生活在澳大利亚农村和偏远地区的患者健康状况不佳,这通常归因于缺乏一系列提供医疗服务的可及医疗专业人员。社区药剂师已经是这些社区不可或缺的一部分,因此往往是咨询最频繁的医疗专业人员。本研究的目的是探索农村药剂师对扩展药房服务的知识和经验,并确定偏远地区药剂师提供扩展药房服务(EPS)的障碍和推动因素,扩展药房服务可被描述为常规药物管理任务之外的服务。
农村和偏远地区的药剂师(莫纳什改良模型(MMM)分类2 - 7类)参与了一项在线调查。进行了描述性统计和卡方检验,并对开放式问题的数据进行了分析、分类成主题并量化。
接受调查的农村药剂师(n = 19)中有三分之二(n = 13,68%)了解农村药房的扩展药房服务,大多数(n = 17,89%)同意这些服务将使农村社区受益。大多数受访者(n = 16,84%)认为心理健康服务转诊非常/极其重要;然而,目前没有药剂师提供心理健康筛查服务,而有15名(79%)愿意提供这些服务。虽然人员短缺、成本、时间和培训被指出是提供扩展药房服务的主要障碍,但推动因素包括农村药房的可及性和感知到的需求。
本研究表明,药剂师已经在提供一些扩展药房服务,并认为其实施具有价值;然而,一些参与者不清楚什么构成扩展服务。心理健康服务被突出为最重要的,这表明农村和偏远地区存在公认的精神疾病负担。这项试点研究的结果将为未来药剂师执业范围的发展和扩展药房服务的实施提供进一步的理解。