识别社区药店药物审查成功实施的因素：药物治疗中的正向偏差。
Identification of factors for a successful implementation of medication reviews in community pharmacies: Using Positive Deviance in pharmaceutical care.
机构信息
Institute of Pharmaceutical and Medicinal Chemistry, Clinical Pharmacy, Westfaelische Wilhelms-University Muenster, Corrensstrasse 48, 48149, Muenster, Germany.
Department of Education and Training, Pharmacists' Chamber of Westphalia-Lippe, Bismarckallee 25, 48151, Muenster, Germany.
出版信息
Int J Clin Pharm. 2022 Feb;44(1):79-89. doi: 10.1007/s11096-021-01315-1. Epub 2021 Aug 6.
UNLABELLED
Background Pharmacists in community pharmacies worldwide successfully conduct an increasing number of medication reviews (MR). Since June 2012 MR are incorporated in the German ordinance on the operation of pharmacies as pharmaceutical service. In November 2014, a German guideline for MR was established. Different teaching programmes for MR were implemented since. Despite these favorable conditions, only few pharmacies conduct MR regularly.
OBJECTIVE
Identification of factors necessary for a successful implementation of MR in community pharmacies.
SETTING
Community pharmacies located in the area of the Pharmacists' Chamber Westphalia-Lippe (Part of Northrhine-Westphalia, Germany).
METHOD
Following a Positive-Deviance approach, telephone interviews were conducted in community pharmacies with pharmacy-owners, MR-trained employed pharmacists, and technicians. Data evaluation was performed using qualitative content analysis.
MAIN OUTCOME RESULTS
Successful strategies for implementing MR in community pharmacies.
RESULTS
Forty-four interviews were conducted and analysed. Thirty-three success factors were identified. Data analysis revealed two groups of success-factors important for implementation of MR; organisational (n = 25) and individual factors (n = 8). Relevant organisational success-factor were involvement of the entire team with active involvement of technicians, documentation of results in the pharmacy software and training in patient-identification and communication. Restructuring of workflows increased time-periods for MR. Important individual success-factors were: motivation and identification with the service, routine in execution to enhance self-esteem, and specialisation in pharmacotherapy of particular diseases. Pharmacy-owners play a pivotal role as motivators. Professional healthcare attitude, exhibited in daily routine, leads to increased acceptance by patients and practitioners and thus increases implementation-rates considerably.
CONCLUSION
We were able to define strategies for successful implementation of MR in community pharmacies.
目的
确定在社区药店成功实施药物评估（MR）所需的因素。
背景
全球的社区药剂师成功地进行了越来越多的药物评估（MR）。自 2012 年 6 月以来，MR 已被纳入德国关于药店运营的规定，作为药物服务的一部分。2014 年 11 月，制定了德国 MR 指南。此后，实施了不同的 MR 教学计划。尽管有这些有利条件，只有少数药店定期进行 MR。
设置
位于西德意志药剂师协会（德国北莱茵-威斯特法伦州的一部分）地区的社区药店。
方法
采用积极偏差方法，对有药房老板、接受过 MR 培训的药剂师和技术员的社区药店进行电话访谈。使用定性内容分析对数据进行评估。
主要结果
成功实施社区药店 MR 的策略。
结果
进行了 44 次访谈并进行了分析。确定了 33 个成功因素。数据分析显示，实施 MR 的两个重要的成功因素组；组织因素（n=25）和个人因素（n=8）。相关的组织成功因素包括整个团队的参与，技术人员的积极参与，在药店软件中记录结果以及在患者识别和沟通方面的培训。工作流程的重组增加了 MR 的时间。重要的个人成功因素包括：对服务的积极性和认同感，执行过程中的常规性以提高自尊心，以及对特定疾病药物治疗的专业化。药房老板作为激励者发挥着关键作用。在日常工作中表现出专业的医疗保健态度，会增加患者和从业者的接受度，从而大大提高实施率。
结论
我们能够确定在社区药店成功实施 MR 的策略。
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