Maritime SPOR SUPPORT Unit, Research, Innovation & Discovery Nova Scotia Health, 5790 University Ave., Halifax, Nova Scotia, B3H1V7, Canada.
Dalhousie University, Nova Scotia, B3H 4R2, Canada.
Res Social Adm Pharm. 2023 Jan;19(1):133-143. doi: 10.1016/j.sapharm.2022.08.014. Epub 2022 Aug 20.
Community pharmacists are positioned to improve access to medications through their ever-expanding role as prescribers, with this role becoming more pronounced during the COVID-19 pandemic.
Our research aimed to determine the extent of self-reported pharmacist prescribing pre-COVID-19 and during the COVID-19 pandemic, to identify barriers and facilitators to pharmacist prescribing, and to explore the relationship between these factors and self-reported prescribing activity.
A questionnaire based on the Theoretical Domains Framework (TDFv2) assessing self-reported prescribing was electronically distributed to all direct patient care pharmacists in NS (N = 1338) in July 2020. Wilcoxon signed-rank tests were used to examine temporal differences in self-reported prescribing activity. TDFv2 responses were descriptively reported as positive (agree/strongly agree), neutral (uncertain), and negative (strongly disagree/disagree) based on the 5-point Likert scale assessing barriers and facilitators to prescribing from March 2020 onward (i.e., 'during' COVID-19). Simple logistic regression was used to measure the relationship between TDFv2 domain responses and self-reported prescribing activity.
A total of 190 pharmacists (14.2%) completed the survey. Over 98% of respondents reported prescribing at least once per month in any of the approved prescribing categories, with renewals being the most common activity reported. Since the pandemic, activity in several categories of prescribing significantly increased, including diagnosis supported by protocol (29.0% vs. 58.9%, p < 0.01), minor and common ailments (25.3% vs 34.7%, p = 0.03), preventative medicine (22.1% vs. 33.2%, p < 0.01). Amongst the TDFv2 domains, Beliefs about Consequences domain had the largest influence on prescribing activity (OR = 3.13, 95% CI 1.41-6.97, p < 0.01), with Social Influences (OR = 2.85, 95% CI 1.42-5.70, p < 0.01) being the next most influential.
Self-reported prescribing by direct patient care community pharmacists in Nova Scotia increased during the COVID-19 pandemic, particularly for government-funded services. Key barriers to address, and facilitators to support pharmacist prescribing were identified and can be used to inform future interventions.
社区药剂师的角色不断扩大，作为处方者，他们能够改善药物的获取途径，在 COVID-19 大流行期间，这种角色变得更加突出。
我们的研究旨在确定在 COVID-19 大流行之前和期间，自我报告的药剂师处方的程度，确定处方的障碍和促进因素，并探讨这些因素与自我报告的处方活动之间的关系。
基于理论领域框架（TDFv2）的问卷，评估自我报告的处方情况，于 2020 年 7 月以电子方式分发给新斯科舍省所有直接患者护理药剂师（N=1338）。使用 Wilcoxon 符号秩检验来检查自我报告的处方活动随时间的差异。基于 2020 年 3 月以来评估处方障碍和促进因素的 5 分李克特量表，将 TDFv2 回复描述为阳性（同意/强烈同意）、中性（不确定）和阴性（强烈不同意/不同意）。简单逻辑回归用于衡量 TDFv2 域响应与自我报告的处方活动之间的关系。
共有 190 名药剂师（14.2%）完成了调查。超过 98%的受访者报告在任何批准的处方类别中每月至少开具一次处方，其中续方是最常见的报告活动。自大流行以来，几种处方类别的活动明显增加，包括协议支持的诊断（29.0%比 58.9%，p<0.01）、轻微和常见疾病（25.3%比 34.7%，p=0.03）、预防医学（22.1%比 33.2%，p<0.01）。在 TDFv2 领域中，信念对后果领域对处方活动的影响最大（OR=3.13，95%CI 1.41-6.97，p<0.01），社会影响（OR=2.85，95%CI 1.42-5.70，p<0.01）是下一个最有影响力的因素。
新斯科舍省直接患者护理社区药剂师的自我报告处方在 COVID-19 大流行期间有所增加，特别是对于政府资助的服务。确定了处方的关键障碍和促进因素，可以为未来的干预措施提供信息。
