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可行性、可及性和可接受性:在农村社区药房开展药剂师主导的耳部健康干预(倾听):澳大利亚昆士兰州的一项混合方法研究。

Feasibility, accessibility and acceptability a pharmacist-led ear health intervention at rural community pharmacies (LISTEN UP): a mixed-methods study in Queensland, Australia.

机构信息

Centre for Rural and Remote Health Mount Isa, James Cook University, Mount Isa, Queensland, Australia

Centre for Rural and Remote Health Mount Isa, James Cook University, Mount Isa, Queensland, Australia.

出版信息

BMJ Open. 2022 Apr 1;12(4):e057011. doi: 10.1136/bmjopen-2021-057011.

Abstract

OBJECTIVE

Ear disease in rural and remote communities is occurring at high rates, with limited access to health services and health providers contributing to the problem. Community pharmacists are well-placed to provide expanded services to improve ear health in rural communities. We aimed to evaluate the feasibility, accessibility and acceptability of a pharmacist-led intervention for ear disease in consumers presenting to community pharmacy.

DESIGN

Prospective preintervention and postintervention mixed-methods study. An ethnographic lens of rural culture was applied to the descriptive qualitative component of the study.

SETTING

Two rural community pharmacies in Queensland, Australia.

PARTICIPANTS

People aged 6 months or older, who present with an ear complaint to a participating community pharmacy.

INTERVENTION

LISTEN UP (Locally Integrated Screening and Testing Ear aNd aUral Programme) is a community pharmacy-based intervention to improve the management of ear health. Trained pharmacists conducted ear examinations using otoscopy and tympanometry on consumers following a LISTEN UP protocol. They made recommendations including no treatment, pharmacy only products or general practitioner (GP) referral. Consumers were contacted 7 days later for follow-up.

RESULTS

55 rural consumers participated in the study. The most commonly reported complaints were 'blocked ear' and 'ear pain'. Pharmacists recommended over-the-counter products to two-thirds of the participants and referred one quarter to a GP. 90% (50/55) of the consumers were highly satisfied with the service and would recommend the service. All consumers described the service positively with particular reference to convenience, improved confidence and appreciation of the knowledge gained about their ear complaint. Pharmacists were motivated to upskill and manage workflow to incorporate the service and expected both consumers and GPs to be more accepting of future expanded services as a result of LISTEN UP. However, without funding to provide the service, during the study other remunerated pharmacy tasks took priority over providing LISTEN UP.

CONCLUSION

Rural community pharmacists can provide an acceptable and accessible ear health service; however, it is not feasible without a clear funding structure to provide resources including additional pharmacists, equipment and training.

TRIAL REGISTRATION NUMBER

ACTRN12620001297910.

摘要

目的

农村和偏远社区的耳部疾病发病率很高,由于获得卫生服务和卫生提供者的机会有限,导致了这一问题。社区药剂师为改善农村社区的耳部健康提供扩展服务的能力很强。我们旨在评估面向到社区药房就诊的消费者的、由药剂师主导的耳部疾病干预措施的可行性、可及性和可接受性。

设计

前瞻性干预前和干预后混合方法研究。该研究的描述性定性部分应用了农村文化的民族志视角。

地点

澳大利亚昆士兰州的两家农村社区药房。

参与者

年龄在 6 个月或以上、到参与社区药房就诊时有耳部不适的人。

干预措施

LISTEN UP(局部综合筛查和测试耳部和耳后程序)是一项基于社区药房的干预措施,旨在改善耳部健康管理。经过 LISTEN UP 方案培训的药剂师对消费者进行耳镜检查和鼓室压测量。他们根据检查结果提出建议,包括无需治疗、使用药房自有产品或转诊至全科医生(GP)。消费者在 7 天后接受随访。

结果

55 名农村消费者参与了研究。最常报告的投诉是“耳塞”和“耳部疼痛”。药剂师建议给三分之二的参与者使用非处方产品,给四分之一的人转诊至 GP。90%(50/55)的消费者对服务非常满意,并表示会推荐该服务。所有消费者都对服务给予了积极的评价,特别提到了便利性、增强了信心以及对他们耳部疾病的了解。药剂师有积极性提高技能并管理工作流程以纳入该服务,并期望由于 LISTEN UP,消费者和 GP 对未来更多扩展服务更能接受。然而,在没有提供资金以提供该服务的情况下,在研究期间,其他有报酬的药房任务优先于提供 LISTEN UP。

结论

农村社区药剂师可以提供可接受且可及的耳部健康服务;然而,如果没有明确的资金结构来提供资源,包括额外的药剂师、设备和培训,该服务则不可行。

试验注册号

ACTRN12620001297910。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa4f/8977761/f82b38481cd1/bmjopen-2021-057011f01.jpg

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