Lubi Kadi, Sepp Kristiina, Rass Hedvig, Roostar Kristiine, Volmer Daisy
Department of Health Technologies, School on Information Technologies, Tallinn University of Technology, Akadeemia Tee 15a, 12618, Tallinn, Estonia.
Health Education Center, Tallinn Health Care College, Kännu 67, 13418, Tallinn, Estonia.
Public Health Pract (Oxf). 2021 Nov;2:100212. doi: 10.1016/j.puhip.2021.100212. Epub 2021 Oct 29.
While healthcare systems struggle to manage the COVID-19 pandemic, community pharmacies have changed the way in which they serve society by ensuring the availability of primary-level medical care. This study aims to examine the rearrangement of service provision at community pharmacies through the prism of social practice theory.
Qualitative in-depth semi-structured interviews.
In total, 21 community pharmacists, 3 hospital pharmacists and 10 experts in Estonia were interviewed. For data analysis, two-dimensional thematic textual analysis was performed according to four types of practices proposed in social practice theory and based on temporal distinction.
The findings of this study reveal that, in order to maintain and improve community pharmacy service provision during the pandemic, there have been changes to all aspects of practice elements, including practical understandings, rules and teleological structures. The majority of challenges were experienced because of necessary changes to the habitual ways of providing pharmacy services, indicating resistance to these changes and reinforcing the need to continue existing 'practice-bundles'. Limited access to healthcare services during the COVID-19 pandemic has resulted in community pharmacists becoming the primary (and only) accessible healthcare contact; thus, leading to a shift in awareness about the role of pharmacists.
Although large-scale changes may result in the dissolvement of practice-bundles and require readiness to adjust current methods of service provision, dissolution is a gradual process. There is an urgent need to support pharmacists in managing the challenges of rearranging service provision, such as immediate organisational changes, lack of information and changing resources.
在医疗系统努力应对新冠疫情之际，社区药房通过确保基层医疗服务的可及性，改变了其服务社会的方式。本研究旨在通过社会实践理论的视角，审视社区药房服务提供的重新安排。
定性深入半结构化访谈。
总共对爱沙尼亚的21名社区药剂师、3名医院药剂师和10名专家进行了访谈。为进行数据分析，根据社会实践理论提出的四种实践类型并基于时间区分，进行了二维主题文本分析。
本研究结果表明，为了在疫情期间维持和改善社区药房服务提供，实践要素的各个方面都发生了变化，包括实践理解、规则和目的论结构。由于药房服务惯常提供方式的必要改变，大多数人面临挑战，这表明对这些变化存在抵触情绪，并强化了继续现有“实践束”的必要性。新冠疫情期间医疗服务可及性有限，导致社区药剂师成为主要（且唯一）可及的医疗接触点；因此，引发了对药剂师角色认识的转变。
尽管大规模变革可能导致实践束的瓦解，并要求准备好调整当前的服务提供方式，但瓦解是一个渐进的过程。迫切需要支持药剂师应对重新安排服务提供所面临的挑战，如即时的组织变革、信息缺乏和资源变化。
