Hussein Rand, Whaley Colin R J, Lin Esther C J, Grindrod Kelly
School of Pharmacy, University of Waterloo, Ontario, Canada.
School of Pharmacy, University of Waterloo, Ontario, Canada; Michael G. DeGroote School of Medicine, McMaster University, Ontario, Canada.
Res Social Adm Pharm. 2021 Aug;17(8):1396-1406. doi: 10.1016/j.sapharm.2020.10.003. Epub 2020 Oct 20.
As pharmacy evolves, pharmacy professionals continue to struggle to practice to their full scope. A theoretically-informed intervention to change practice can support pharmacy professionals in providing full scope services. The Theoretical Domains Framework (TDF) can inform the design of a behaviour change intervention to improve the uptake of full scope services among pharmacy professionals.
This study aimed to: (1) identify barriers and facilitators influencing the adoption of full scope services among pharmacy professionals, and (2) identify optimal behaviour change techniques (BCTs) to address the identified barriers and facilitators.
A three-step, mixed method study was conducted. First, a 24-item TDF-based survey was sent via email to users of a national computer-based educational platform (n = 2696). Second, TDF-based interviews were conducted with a convenient sample of survey respondents and analyzed using the framework method. Finally, validated linkages were used to link BCTs with corresponding barriers and facilitators, then interview data were analyzed using a deductive approach to guide the selection of the BCTs.
A total of 225 participants completed the survey and 24 telephone interviews were conducted (17 pharmacists, 7 pharmacy technicians). A number of key barriers were identified on an individual level (e.g., lack of clear professional identity and limited decision-making skills in ambiguous cases) and on an organizational level (e.g., lack of social support from managers and concerns about making more errors with the current workflow). Mapping the barriers and facilitators to BCTs yielded 18 BCTs to support the adoption of full scope services, including modeling, rehearsal/practice, and social support.
This study highlighted several barriers that need to be addressed to facilitate pharmacy professionals working to their full scope, including professional collaboration, professional identity, and adequate training. A comprehensive intervention combining skills training with modeling, social support, and decision-making tools could encourage practice change.
随着药学行业的发展，药学专业人员仍在努力充分发挥其专业能力。基于理论的实践变革干预措施可以支持药学专业人员提供全面服务。理论领域框架（TDF）可为行为改变干预措施的设计提供参考，以提高药学专业人员对全面服务的接受程度。
本研究旨在：（1）确定影响药学专业人员采用全面服务的障碍和促进因素；（2）确定解决已识别的障碍和促进因素的最佳行为改变技术（BCT）。
开展了一项分三步进行的混合方法研究。首先，通过电子邮件向一个全国性计算机教育平台的用户（n = 2696）发送了一份基于TDF的24项调查问卷。其次，对调查问卷受访者的便利样本进行了基于TDF的访谈，并使用框架法进行分析。最后，利用经过验证的关联将BCT与相应的障碍和促进因素联系起来，然后采用演绎法对访谈数据进行分析，以指导BCT的选择。
共有225名参与者完成了调查，并进行了24次电话访谈（17名药剂师，7名药房技术员）。在个人层面（例如，缺乏明确的职业身份以及在模糊情况下决策技能有限）和组织层面（例如，缺乏来自管理人员的社会支持以及担心当前工作流程会导致更多错误）确定了一些关键障碍。将障碍和促进因素与BCT进行映射分析，得出了18项支持采用全面服务的BCT，包括示范、排练/练习和社会支持。
本研究突出了几个需要解决的障碍，以促进药学专业人员充分发挥其专业能力，包括专业协作、职业身份和充分培训。将技能培训与示范、社会支持和决策工具相结合的综合干预措施可能会促进实践变革。
