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识别社区药剂师在常规配药中药物风险管理能力的差距。

Identifying Gaps in Community Pharmacists' Competence in Medication Risk Management in Routine Dispensing.

作者信息

Kallio Sonja, Eskola Tiina, Airaksinen Marja, Pohjanoksa-Mäntylä Marika

机构信息

Clinical Pharmacy Group, Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Finland.

Hyvinkää 3 Pharmacy, Hyvinkää, Finland.

出版信息

Innov Pharm. 2021 Feb 11;12(1). doi: 10.24926/iip.v12i1.3510. eCollection 2021.

Abstract

BACKGROUND

Community pharmacists increasingly contribute to medication risk management while dispensing medicines to outpatients. Their risk management actions are shifting from medication counselling towards reviewing medications and following-up their therapeutic effects and outcomes. Acquiring these more clinical tasks require more patient care-oriented competences.

OBJECTIVE

To identify gaps in community pharmacists' competence in medication risk management in routine dispensing.

SETTING

All community pharmacies in Finland.

METHOD

A national cross-sectional online survey was conducted through the Association of Finnish Pharmacies (n=574 community pharmacies) and the university pharmacies (n=2) in 2015. One pharmacist from each pharmacy was recommended to report on behalf of their outlet.

MAIN OUTCOME MEASURE

Community pharmacists' self-assessed competence to: 1) identify medication-related risks, 2) utilise electronic tools in medication risk management, and 3) identify their perceived needs for developing competence in medication risk management.

RESULTS

Responses were received from 169 community pharmacies (response rate 29%). The highest proportion of good competency estimates were self-assessed in confirming doses (98% of the respondents evaluated their competence to be good) and identifying drug-drug interactions (83%). Competence to identify adverse effects, such as serotonergic load (10%) and anticholinergic load (12%), was most seldomly perceived as good. Of the wide range of electronic databases available, respondents most commonly reported using daily summaries of product characteristics (97% of the respondents), the checklist-type generic medicines information database that supports in medication counselling (85%), and the programme assisting in identifying drug-drug interactions (83%). The most commonly reported training needs were related to the identification of serotonergic load (63%), anticholinergic load (62%), and evaluating the clinical significance of drug-drug interactions (54%).

CONCLUSION

The results indicate remarkable gaps in community pharmacists' current competence in medication risk management, particularly in their competence in applied and geriatric pharmacotherapy.

摘要

背景

社区药剂师在为门诊患者配药时,对药物风险管理的贡献日益增加。他们的风险管理行动正从药物咨询转向审查药物以及跟踪其治疗效果和结果。承担这些更多的临床任务需要更多以患者护理为导向的能力。

目的

确定社区药剂师在常规配药中药物风险管理能力方面的差距。

地点

芬兰所有社区药房。

方法

2015年通过芬兰药房协会(574家社区药房)和大学药房(2家)进行了一项全国性横断面在线调查。建议每家药房的一名药剂师代表其药房进行报告。

主要观察指标

社区药剂师自我评估的能力:1)识别与药物相关的风险,2)在药物风险管理中使用电子工具,3)识别他们认为在药物风险管理能力发展方面的需求。

结果

收到了169家社区药房的回复(回复率29%)。在确认剂量(98%的受访者认为自己在此方面能力良好)和识别药物相互作用(83%)方面,自我评估为能力良好的比例最高。识别不良反应的能力,如血清素能负荷(10%)和抗胆碱能负荷(12%),很少被认为是良好的。在众多可用的电子数据库中,受访者最常报告使用产品特征每日摘要(97%的受访者)、支持药物咨询的清单式通用药品信息数据库(85%)以及协助识别药物相互作用的程序(83%)。最常报告的培训需求与血清素能负荷的识别(63%)、抗胆碱能负荷的识别(62%)以及评估药物相互作用的临床意义(54%)有关。

结论

结果表明社区药剂师目前在药物风险管理能力方面存在显著差距,特别是在应用和老年药物治疗方面的能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbfa/8102976/32b572ba51a5/21550417-12-01-3510-g1.jpg

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