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全科医生与社区药剂师在初级医疗保健中的合作:重大变革的小步迈进。

General Practitioners and Community Pharmacists' Collaboration in Primary Care: Small Steps for a Major Change.

作者信息

Damiaens Amber, Fraeyman Jessica, Fakroune Sarah, Hutsebaut Caroline, Roussel Sandrine, Van Dyck Lieve, Van Hal Guido, Van den Broucke Stephan, Foulon Veerle

机构信息

Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Herestraat 49, B-3000, Leuven, Belgium.

Association of Community Health Centers, Vooruitgangstraat 333 box 10, B-1030 Brussels.

出版信息

Int J Integr Care. 2021 Apr 23;21(2):10. doi: 10.5334/ijic.5612.

Abstract

BACKGROUND

Healthcare authorities worldwide search for ways to develop integrated care and interprofessional collaboration. In Belgium, Medical-Pharmaceutical Concertation (MPC) was introduced as a format to promote constructive dialogues between GPs and community pharmacists (CPs) with a focus on pharmacotherapy.

OBJECTIVE

To evaluate the implementation of MPC from the perspective of healthcare authorities and GPs/CPs.

METHODS

Mixed-methods approach, including semi-structured interviews with stakeholders and service users, observations of MPC meetings and surveys in GPs/CPs. Quantitative data were analyzed using descriptive statistics. Qualitative data were analyzed inductively.

RESULTS

The implementation of MPC took a slow start. Parties involved had divergent views on the goals of the MPC: stakeholders focused on measurable results, while service users aimed on improving interprofessional communication. Additionally, service users felt that the lack of local structures hindered consensus building and implementation of agreements in daily practice. Support from professional associations was considered indispensable for the implementation of MPC. In order to organize this efficiently, the establishment of an independent institution, coordinating the MPC initiative, was highly recommended.

CONCLUSION

The study confirms that a thorough context assessment prior to implementation of a complex project is needed and that a step-wise approach should be respected to achieve effective interprofessional relationships.

摘要

背景

全球医疗保健当局都在寻求发展综合护理和跨专业协作的方法。在比利时,引入了医疗-药学协调(MPC)作为一种促进全科医生(GPs)与社区药剂师(CPs)之间建设性对话的形式,重点是药物治疗。

目的

从医疗保健当局以及全科医生/社区药剂师的角度评估MPC的实施情况。

方法

采用混合方法,包括对利益相关者和服务使用者进行半结构化访谈、观察MPC会议以及对全科医生/社区药剂师进行调查。定量数据采用描述性统计进行分析。定性数据采用归纳法进行分析。

结果

MPC的实施起步缓慢。参与各方对MPC的目标存在不同看法:利益相关者关注可衡量的结果,而服务使用者旨在改善跨专业沟通。此外,服务使用者认为缺乏地方架构阻碍了在日常实践中建立共识和执行协议。专业协会的支持被认为是MPC实施不可或缺的。为了有效组织这一工作,强烈建议设立一个独立机构来协调MPC倡议。

结论

该研究证实,在实施复杂项目之前需要进行全面的背景评估,并且应该遵循逐步推进的方法以实现有效的跨专业关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a162/8064283/92717c0187b3/ijic-21-2-5612-g1.jpg

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