Palaian Subish, Buabeid Manal, Ashames Akram
Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates.
Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates.
Risk Manag Healthc Policy. 2020 Dec 31;13:3201-3209. doi: 10.2147/RMHP.S282571. eCollection 2020.
Community pharmacists are in a unique position to identify drug therapy-related problems (DTRPs) in prescriptions and mitigate them by communicating with prescriber. This study assessed the ability of community pharmacists (CPs) to identify DTRPs in prescriptions, the level of interprofessional collaboration among physician and CPs in mitigating the identified DTRPs, and the existing safety culture practices among CPs.
Trained simulated patients (SPs), five final-year BSc Pharm female students, visited conveniently selected community pharmacies ( = 50) in Ajman emirate of the United Arab Emirates, with dummy prescriptions containing DTRPs (total 50 prescriptions with five different types of DTRPs categorized per the Pharmaceutical Care Network Europe Version 8) and assessed the DTRP-identifying ability of the CPs. SPs also observed the steps taken by the CPs to mitigate identified DTRPs and existing (if any) collaborative practices between CPs and physician. SPs documented their observations in a checklist immediately after leaving the pharmacy premises, which served as the data source. Statistical analyses were performed with chi-square at alpha = 0.05.
Of the 50 respondents, 44% ( = 22) were able to identify the DTRPs. DTRP identification by pharmacists was associated with labeling [chi-square = 7.879, value = 0.019], reconciliation [chi-square = 10.359, value = 0.001], counseling standard [chi-square = 19.09, = 0.000] and physician visit suggestion [chi-square = 31.15, = 0.000]. The labeling standards for prescriptions with DTRPs were "low" in five (50%), "average" in three (30%) and "good" in two (20%) of the cases with wrong dose. Average counseling time of the CPs was 80.38 ± 71.61 seconds. The counseling standard had no significant association with counseling time [chi-square = 34.79, = 0.250] and use of drug information sources [chi-square = 2.86, = 0.243]. Average time spent in dispensing is 74.4 ± 73.05 seconds. None ( = 0) of the CPs communicated with the physician, and only five out of 50 (10%) of CPs checked any DI sources. However, in 19 (38%) cases, the CPs recommended the SPs to consult their physician prior to taking the medications.
CPs were generally able to identify DTRPs and mitigate DTRPs by recommending physician consultation. Nevertheless, there were no professional collaborations between the SPs and physicians. The dispensing and counseling standards were not appreciable.
社区药剂师处于独特地位，能够识别处方中与药物治疗相关的问题（DTRP），并通过与开处方者沟通来缓解这些问题。本研究评估了社区药剂师识别处方中DTRP的能力、医生与社区药剂师在缓解已识别的DTRP方面的跨专业协作水平，以及社区药剂师现有的安全文化实践。
经过培训的模拟患者（SP），即五名药学专业本科最后一年的女学生，走访了阿拉伯联合酋长国阿治曼酋长国方便选取的社区药房（共50家），携带包含DTRP的虚拟处方（共50张处方，按照欧洲药学保健网络第8版对五种不同类型的DTRP进行分类），并评估社区药剂师识别DTRP的能力。SP还观察了社区药剂师为缓解已识别的DTRP所采取的步骤，以及社区药剂师与医生之间现有的（如有）协作实践。SP在离开药房后立即在检查表中记录他们的观察结果，该检查表作为数据源。采用卡方检验进行统计分析，显著性水平α = 0.05。
在50名受访者中，44%（n = 22）能够识别DTRP。药剂师识别DTRP与标签[卡方 = 7.879，P值 = 0.019]、核对[卡方 = 10.359，P值 = 0.001]、咨询标准[卡方 = 19.09，P = 0.000]和建议看医生[卡方 = 31.15，P = 0.000]相关。在剂量错误的病例中，有五种（50%）的DTRP处方标签标准为“低”，三种（30%）为“中等”，两种（20%）为“良好”。社区药剂师的平均咨询时间为80.38 ± 71.61秒。咨询标准与咨询时间[卡方 = 34.79，P = 0.250]和药物信息来源的使用[卡方 = 2.86，P = 0.243]无显著关联。平均配药时间为74.4 ± 73.05秒。没有社区药剂师与医生沟通，50名社区药剂师中只有五名（10%）查阅了任何药物信息来源。然而，在19例（38%）中，社区药剂师建议模拟患者在服药前咨询医生。
社区药剂师通常能够识别DTRP，并通过建议患者咨询医生来缓解DTRP。然而，模拟患者与医生之间没有专业协作。配药和咨询标准不尽人意。
