Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
Int J Clin Pharm. 2023 Jun;45(3):758-768. doi: 10.1007/s11096-023-01571-3. Epub 2023 Apr 8.
Community pharmacies are easily accessible for self-care advice. Guidelines for providing self-care advice were introduced in several countries, including the Netherlands in the 1990s. Previous studies have indicated room for improvement in self-care advice in daily pharmacy practice.
To identify barriers and facilitators for providing self-care advice.
Semi-structured interviews were conducted face-to-face or online with pharmacists and pharmacy assistants using a topic guide based on the Theoretical Domains Framework. The interviews were audio-recorded and transcribed verbatim. The transcripts were deductively analysed to identify barriers and facilitators for self-care counselling. COREQ guidelines were followed.
In total, 13 pharmacists and 12 pharmacy assistants were interviewed to reach data saturation. In general, most themes addressed by pharmacists and pharmacy assistants belonged to similar domains. The following domains were frequently mentioned: environmental context and resources (e.g. priority for prescription drugs, privacy, collaboration with general practitioners, access to patients' records), intentions (providing reliable advice), skills (communication, decision-making), knowledge (ready guideline knowledge), beliefs about consequences (patient safety), social influences (patient awareness of pharmacist role), reinforcement (lack of reimbursement for relatively time-consuming advice).
This study identifies barriers and facilitators for evidence-based self-care advice. Pharmacists should first support pharmacy assistants by helping them keep their knowledge and skills up to date and creating suitable pharmacy preconditions to facilitate improvements in self-care counselling. Second, collaboration with general practitioners regarding minor ailments should be improved.
社区药店便于提供自我护理建议。包括荷兰在内的多个国家都出台了提供自我护理建议的指南。先前的研究表明，日常药店实践中提供自我护理建议还有改进的空间。
确定提供自我护理建议的障碍和促进因素。
采用基于理论领域框架的主题指南，对药剂师和药房助理进行面对面或在线半结构化访谈。访谈进行了录音并逐字转录。根据 COREQ 指南，对转录本进行演绎分析，以确定自我护理咨询的障碍和促进因素。
共采访了 13 名药剂师和 12 名药房助理，直到达到数据饱和。总的来说，药剂师和药房助理提到的大多数主题都属于相似的领域。以下领域经常被提及：环境背景和资源（例如，处方药的优先级、隐私、与全科医生的合作、访问患者记录）、意图（提供可靠的建议）、技能（沟通、决策）、知识（现成的指南知识）、信念后果（患者安全）、社会影响（患者对药剂师角色的认识）、强化（相对耗时的建议缺乏报销）。
本研究确定了基于证据的自我护理建议的障碍和促进因素。药剂师首先应该通过帮助药房助理更新他们的知识和技能，并创造合适的药店条件来支持他们，从而促进自我护理咨询的改进。其次，应改善与全科医生在小病方面的合作。
