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社区药房采用药物同步服务的障碍、促进因素及实际解决方案探索:一项定性分析

An exploration of barriers, facilitators, and practical solutions for adopting medication synchronization into community pharmacies: A qualitative analysis.

作者信息

Hughes Tamera D, Cutrell Stacey, Minshew Lana M, Brown Patrick, Ferreri Stefanie P

机构信息

University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC, United States of America.

Medical College of Wisconsin, Robert and Patricia Kern Institute for the Transformation of Medical Education and School of Pharmacy, Milwaukee, WI, United States of America.

出版信息

Explor Res Clin Soc Pharm. 2022 Feb 3;5:100111. doi: 10.1016/j.rcsop.2022.100111. eCollection 2022 Mar.

Abstract

BACKGROUND

Community pharmacies across the nation have adopted medication synchronization (Med Sync) services with the aim of improving medication adherence. To help incorporate Med Sync into a pharmacy's workflow, pharmacy associations and organizations developed implementation guides for community pharmacies. However, considerable variability in the adoption of this service exists as pharmacies struggle to implement Med Sync into traditional workflow. Researchers identified early adopters of Med Sync who dispense majority of their prescriptions as part of a Med Sync program. An exploratory study was undertaken with the aim to reveal themes surrounding facilitators and barriers to adoption of Med Sync in community pharmacies.

OBJECTIVES

The objective of this study was to explore the barriers and facilitators associated with Med Sync adoption in community pharmacies and generate practical solutions for service adoption. Methods Community pharmacies participating in the North Carolina's Community Pharmacy Enhanced Services Network (CPESNsm) who were early adopters of Med Sync and had greater than 50% of their prescription volume being dispensed as part of a Med Sync program were recruited to participate in semi-structured interviews. Interviews were conducted, recorded, and transcribed verbatim with representatives who led the adoption of Med Sync in their pharmacy. Inductive coding and summary analysis were used to analyze the interview data and determine themes associated with facilitators and barriers.

RESULTS

Analysis of the interviews revealed four key themes: program organization, staff engagement, patient engagement, and provider engagements for Med Sync adoption. Each of these themes had several sub-themes, contributing to facilitators and barriers to Med Sync adoption. Subthemes of program organization included having organizational infrastructure, including a pharmacy software system, a dedicated area, and a consistent enrollment process. Subthemes of staff engagement included having a team-based approach, job training, and staff incentives. Patient engagement's subthemes included communication, finances, health literacy, and transportation. Provider engagement resulted with subthemes including lack of communication and provider-pharmacist relationships.

CONCLUSION

To ensure successful adoption of Med Sync into traditional workflow, community pharmacies should employ a multi-factorial approach that includes internal and external components to the community pharmacy. This study identified facilitators associated with successful Med Sync adoption such as adequate staff engagement and requisite program organization. Barriers hindering successful Med Sync adoption resulted from challenges with provider and patient engagement. This study also makes an important contribution by providing practical solutions to Med Sync adoption based on participant responses and identified themes and sub-themes.

摘要

背景

全国各地的社区药房都采用了药物同步(Med Sync)服务,旨在提高药物依从性。为了帮助将Med Sync纳入药房的工作流程,药房协会和组织为社区药房制定了实施指南。然而,由于药房在努力将Med Sync纳入传统工作流程时面临困难,这项服务的采用情况存在很大差异。研究人员确定了Med Sync的早期采用者,他们将大部分处方作为Med Sync计划的一部分进行配药。开展了一项探索性研究,旨在揭示社区药房采用Med Sync的促进因素和障碍相关的主题。

目的

本研究的目的是探讨社区药房采用Med Sync的障碍和促进因素,并为服务采用提出切实可行的解决方案。方法招募参与北卡罗来纳州社区药房强化服务网络(CPESNsm)且是Med Sync早期采用者、其处方量超过50%作为Med Sync计划一部分进行配药的社区药房,让其参与半结构化访谈。与在其药房领导Med Sync采用的代表进行访谈、录音并逐字转录。采用归纳编码和总结分析来分析访谈数据,并确定与促进因素和障碍相关的主题。

结果

访谈分析揭示了四个关键主题:Med Sync采用的项目组织、员工参与、患者参与和提供者参与。这些主题中的每一个都有几个子主题,促成了Med Sync采用的促进因素和障碍。项目组织的子主题包括拥有组织基础设施,包括药房软件系统、专用区域和一致的注册流程。员工参与的子主题包括采用基于团队的方法、工作培训和员工激励措施。患者参与的子主题包括沟通、财务、健康素养和交通。提供者参与产生的子主题包括缺乏沟通和提供者与药剂师的关系。

结论

为确保Med Sync成功纳入传统工作流程,社区药房应采用多因素方法,包括社区药房的内部和外部组成部分。本研究确定了与Med Sync成功采用相关的促进因素,如充分的员工参与和必要的项目组织。阻碍Med Sync成功采用的障碍源于提供者和患者参与方面的挑战。本研究还通过根据参与者的回答以及确定的主题和子主题为Med Sync采用提供切实可行的解决方案做出了重要贡献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3cae/9030300/ecb4e4ffb607/gr1.jpg

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