药剂师独立处方者融入全科医疗：一项关于药剂师和患者观点的混合方法研究。
Integration of pharmacist independent prescribers into general practice: a mixed-methods study of pharmacists' and patients' views.
作者信息
Alshehri Abdullah A, Hindi Ali M K, Cheema Ejaz, Sayeed Haque M, Jalal Zahraa, Yahyouche Asma
机构信息
Clinical Pharmacy Department, College of Pharmacy, Taif University, Al Huwaya, Taif, 26571, Saudi Arabia.
School of Pharmacy, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
出版信息
J Pharm Policy Pract. 2023 Jan 19;16(1):10. doi: 10.1186/s40545-023-00520-9.
BACKGROUND
Since 2015, the National Health Service (NHS) has funded pharmacists to work in general practice (GP practice) to ease workload pressures. This requires pharmacists to work in new roles and be integrated effectively in GPs. Independent prescribing is a key part of the GP pharmacist role, but little is known about pharmacists' integration into GP practice as well as patients' perceptions and experiences of the care provided by GP pharmacists. This study aims to explore the perceptions of pharmacist independent prescribers (PIPs) about their integration into GP practice and gain insight into patients' perceptions about the care provided to them by pharmacists.
METHODS
A mixed-methods study comprising semi-structured interviews with PIPs (n = 13) followed by questionnaire-based assessment of patients' (n = 77) evaluation of pharmacists' care was conducted between December 2019 and March 2020. Quantitative data were analysed using descriptive statistics. Interviews and open comments of the survey were thematically analysed.
RESULTS
Pharmacist independent prescribers reported undertaking a range of patient-facing and non-clinical roles. Lack of understanding about PIPs' clinical role and working beyond their clinical area of competence were some of the barriers to their integration into GP practice. Most patients were satisfied with the consultations they received from pharmacists and reported confidence in the pharmacist's recommendations about their health conditions. However, a few patients (14%) felt they would still need to consult a general practitioner after their appointment and 11% were not sure if a further consultation was needed.
CONCLUSIONS
Pharmacist independent prescribers provide a range of clinical services for the management of long-term conditions which appear to be recognised by patients. However, there is a need to address the barriers to PIPs' integration into GP practice to optimise their skill-mix and patient-centred care.
背景
自2015年以来，英国国家医疗服务体系（NHS）资助药剂师在全科医疗（GP诊所）工作，以缓解工作量压力。这要求药剂师承担新的角色，并有效地融入全科医生团队。独立处方权是全科药剂师角色的关键部分，但对于药剂师融入全科医疗实践以及患者对全科药剂师提供的护理的看法和体验，人们了解甚少。本研究旨在探讨药剂师独立处方者（PIPs）对其融入全科医疗实践的看法，并深入了解患者对药剂师为他们提供的护理的看法。
方法
2019年12月至2020年3月期间，开展了一项混合方法研究，包括对13名PIPs进行半结构化访谈，随后对77名患者对药剂师护理的评价进行基于问卷的评估。定量数据采用描述性统计进行分析。对访谈和调查的开放式评论进行主题分析。
结果
药剂师独立处方者报告承担了一系列面向患者和非临床的角色。对PIPs临床角色缺乏了解以及在其临床能力范围之外开展工作是他们融入全科医疗实践的一些障碍。大多数患者对从药剂师那里获得的咨询感到满意，并表示对药剂师关于其健康状况的建议有信心。然而，少数患者（14%）觉得在预约后仍需要咨询全科医生，11%的患者不确定是否需要进一步咨询。
结论
药剂师独立处方者为长期病症的管理提供了一系列临床服务，这些服务似乎得到了患者的认可。然而，有必要解决PIPs融入全科医疗实践的障碍，以优化他们的技能组合和以患者为中心的护理。
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