Mubarak Naeem, Raja Sarwat Ali, Khan Asma Sarwar, Kanwal Sabba, Saif-Ur-Rehman Nasira, Aziz Muhammad Majid, Hussain Irshad, Hatah Ernieda, Zin Che Suraya
Department of Pharmacy Practice, Lahore Medical & Dental College, University of Health Sciences, Lahore, Punjab, Pakistan.
Department of Pharmacy Practice, University of Health Sciences, Lahore, Punjab, Pakistan.
Risk Manag Healthc Policy. 2021 Apr 19;14:1615-1627. doi: 10.2147/RMHP.S296113. eCollection 2021.
There is a growing global interest in formulating such policies and strategic plans that help devise collaborative working models for community pharmacists (CPs) and general practitioners (GPs) in primary care settings.
To conceptualize a stakeholder-driven framework to improve collaboration between CPs and GPs in Malaysian primary care to effectively manage medicines in chronic diseases.
A qualitative study that involved individual semi-structured interviews of the leadership of various associations, guilds, and societies representing CPs, GPs, and Nurses in Malaysia.
This study collected and reported data in accordance with the guidelines of the Consolidated Criteria for Reporting of Qualitative Studies. Key informants were recruited based on purposive (expert) sampling. Interviews were transcribed verbatim and data were coded based on the principles of thematic analysis in NVivo.
A total of 12 interviews (5 CPs, 5 GPs, and 2 nurses) were conducted. Five themes emerged: Theme 1 highlighted a comparison of community pharmacy practice in Malaysia and developed countries; Theme 2 involved current practices in Malaysian primary care; Theme 3 encompassed the advantages of CP-GP collaboration in chronic diseases; Theme 4 highlighted the barriers which impede collaboration in Malaysian primary care; and Theme 5 delineated the way forward for CP-GP collaboration in Malaysia.
The actionable insights obtained from the Malaysian stakeholders offered an outline of a framework to enhance collaboration between CPs and GPs in primary care. Generally, stakeholders were interested in CP-GP collaboration in primary care and identified many positive roles performed by CPs, including prescription review, adherence support, and patient education. The framework of the way forward includes: separation of CP and GP roles through a holistic revision of relevant legislation to grant an active role to CPs in chronic care; definition of protocols for collaborative practices; incentivization of both stakeholders (CPs and GPs); and design and implementation of an effective regulatory mechanism whereby the Malaysian Ministry of Health may take a leading role.
全球对于制定相关政策和战略计划的兴趣与日俱增，这些政策和计划有助于为基层医疗环境中的社区药剂师（CP）和全科医生（GP）设计协作工作模式。
构建一个由利益相关者驱动的框架，以改善马来西亚基层医疗中CP与GP之间的协作，从而有效管理慢性病用药。
一项定性研究，涉及对马来西亚代表CP、GP和护士的各协会、行会及社团领导进行的个人半结构化访谈。
本研究按照定性研究报告统一标准的指南收集和报告数据。关键信息提供者通过立意（专家）抽样招募。访谈逐字转录，数据在NVivo中根据主题分析原则进行编码。
共进行了12次访谈（5名CP、5名GP和2名护士）。出现了五个主题：主题1强调了马来西亚与发达国家社区药房实践的比较；主题2涉及马来西亚基层医疗中的当前实践；主题3涵盖了CP-GP在慢性病方面协作的优势；主题4强调了阻碍马来西亚基层医疗协作的障碍；主题5描绘了马来西亚CP-GP协作的前进方向。
从马来西亚利益相关者处获得的可操作见解提供了一个框架大纲，以加强基层医疗中CP与GP之间的协作。总体而言，利益相关者对基层医疗中的CP-GP协作感兴趣，并确定了CP所发挥的许多积极作用，包括处方审核、依从性支持和患者教育。前进方向的框架包括：通过全面修订相关立法来区分CP和GP的角色，以使CP在慢性病护理中发挥积极作用；定义协作实践的规程；激励双方利益相关者（CP和GP）；以及设计和实施有效的监管机制，使马来西亚卫生部能够发挥主导作用。
