School of Pharmacy, Institute of Clinical Sciences, College of Medical and Dental Sciences, Sir Robert Aitken Institute for Medical Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
Int J Clin Pharm. 2022 Feb;44(1):180-191. doi: 10.1007/s11096-021-01331-1. Epub 2021 Oct 2.
Background Opioid are currently widely used to manage chronic non-malignant pain (CNMP), but there is a growing concern about harm resulting from opioid misuse and the need for medicine optimization, in which pharmacists could potentially play a key role. Objective This study explored pharmacists' roles, barriers and determinants related to their involvement in optimizing prescribed opioids for patients with chronic pain. Setting Community pharmacies in the United Kingdom. Method Semi-structured interviews based on the Theoretical Domains Framework were conducted between January and May 2020 with 20 community pharmacists recruited through professional networks. Data were analysed thematically. Main outcome measure: Pharmacists' perceived roles, barriers and behavioural determinants in relation to opioid therapy optimization. Result Pharmacists demonstrated desire to contribute to opioid therapy optimization. However, they described that they were often challenged by the lack of relevant knowledge, skills and training, inadequate time and resources, systemic constraints (such as lack of access to medical records and information about diagnosis), and other barriers including relationships with doctors and patients. Conclusion The contribution of community pharmacists to optimize opioid therapy in CNMP is unclear and impeded by lack of appropriate training and systemic constraints. There is a need to develop innovative practice models by addressing the barriers identified in this study to enhance the contribution of community pharmacists in optimization of opioid therapy for chronic pain.
背景 阿片类药物目前被广泛用于治疗慢性非恶性疼痛（CNMP），但人们越来越担心阿片类药物滥用造成的危害，以及优化药物治疗的必要性，药剂师在其中可能发挥关键作用。目的 本研究探讨了药剂师在参与优化慢性疼痛患者处方阿片类药物方面的角色、障碍和决定因素。 地点 英国社区药房。 方法 2020 年 1 月至 5 月，通过专业网络招募了 20 名社区药剂师，采用基于理论领域框架的半结构式访谈。对数据进行主题分析。 主要结果措施：药剂师在优化阿片类药物治疗方面的感知角色、障碍和行为决定因素。 结果 药剂师表现出愿意为优化阿片类药物治疗做出贡献。然而，他们描述说，他们经常受到缺乏相关知识、技能和培训、时间和资源不足、系统限制（例如无法访问医疗记录和诊断信息）以及与医生和患者的关系等其他障碍的挑战。 结论 社区药剂师对优化 CNMP 中阿片类药物治疗的贡献尚不清楚，并且受到缺乏适当培训和系统限制的阻碍。需要通过解决本研究中确定的障碍来开发创新的实践模式，以增强社区药剂师在优化慢性疼痛阿片类药物治疗方面的贡献。
