Tong Vivien, Krass Ines, Aslani Parisa
The University of Sydney School of Pharmacy, Faculty of Medicine and Health, Pharmacy and Bank Building (A15), Science Road, The University of Sydney, Camperdown, NSW 2006, Australia.
Explor Res Clin Soc Pharm. 2021 Aug 8;3:100060. doi: 10.1016/j.rcsop.2021.100060. eCollection 2021 Sep.
A substantial expansion in the scope of practice of community pharmacists has become evident over the years, with increased government remuneration pledged to support cognitive pharmaceutical services (CPS) delivery as part of the Australian Community Pharmacy Agreements. Exploring experiences in providing funded and unfunded CPS within the existing work environment will enable better understanding of community pharmacists' roles and responsibilities in delivering CPS.
To explore pharmacists' roles, responsibilities, experiences, and perceived impact associated with delivering CPS.
Qualitative semi-structured interviews ( = 25) were conducted with practising community pharmacists in Australia who were engaged in delivering CPS during the time when the Sixth Community Pharmacy Agreement (6CPA) was in effect. Verbatim transcripts were thematically analysed (inductive analysis).
All participants reported an expansion of services being provided in community pharmacies. Pharmacists offered a broad range of CPS within the community pharmacy setting, via 6CPA-funded and non-6CPA or unfunded initiatives. Almost all participants reported that their pharmacy provided 6CPA-funded initiatives such as dose administration aids, clinical interventions, MedsChecks/Diabetes MedsChecks, and Home Medicines Reviews. User-pay services being offered included pharmacist-led flu vaccinations, opioid substitution therapy, sleep apnoea services, and absence from work certificates, among other services. However, profit margins on user-pay services were minimal. CPS provision was seen to have positive impacts at patient and health care system levels. Pharmacists felt they enabled timely and convenient access to health care for patients in the community pharmacy setting, and facilitated quality use of medicines, which in turn had positive impact on the community pharmacy business.
A prominent shift in the provision of CPS was evident. Professional services provision has become the status quo for the practice of the profession, indicative of a likely shift in the work value of community pharmacists. Pharmacists should be further recognised professionally and financially for their contributions as health care professionals within the broader health care system.
多年来，社区药剂师的执业范围有了显著扩大，政府承诺增加薪酬以支持认知药学服务（CPS）的提供，这是澳大利亚社区药房协议的一部分。探索在现有工作环境中提供有偿和无偿CPS的经验，将有助于更好地理解社区药剂师在提供CPS方面的角色和责任。
探讨药剂师在提供CPS方面的角色、责任、经验和感知影响。
对澳大利亚从事CPS工作的执业社区药剂师进行了定性半结构化访谈（n = 25），访谈时间为第六份社区药房协议（6CPA）生效期间。对逐字记录进行了主题分析（归纳分析）。
所有参与者都报告称社区药房提供的服务有所扩展。药剂师通过6CPA资助的以及非6CPA或无资助的举措，在社区药房环境中提供了广泛的CPS。几乎所有参与者都报告称他们的药房提供了6CPA资助的举措，如剂量给药辅助工具、临床干预、药物检查/糖尿病药物检查以及家庭药物审查。提供的自费服务包括药剂师主导的流感疫苗接种、阿片类药物替代疗法、睡眠呼吸暂停服务以及病假证明等其他服务。然而，自费服务的利润率很低。CPS的提供在患者和医疗保健系统层面都产生了积极影响。药剂师认为他们在社区药房环境中为患者提供了及时便捷的医疗服务，并促进了药物的合理使用，这反过来又对社区药房业务产生了积极影响。
CPS的提供发生了显著转变。提供专业服务已成为该行业的现状，这表明社区药剂师的工作价值可能发生了转变。作为更广泛医疗保健系统中的医疗保健专业人员，药剂师的贡献应在专业和经济上得到进一步认可。
