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药剂师在药物使用过程中的角色:患者、医生和药剂师的看法。

Pharmacist roles in the medication use process: Perceptions of patients, physicians, and pharmacists.

作者信息

Kim Eunhee, Worley Marcia M, Law Anandi V

出版信息

J Am Pharm Assoc (2003). 2023 Jul-Aug;63(4):1120-1130. doi: 10.1016/j.japh.2023.05.013. Epub 2023 May 18.

Abstract

OBJECTIVES

It is uncertain whether stakeholder perceptions of pharmacist roles in the medication use process (MUP) have evolved alongside pharmacist advanced scope of practice. This study aimed to examine patient, pharmacist, and physician perceptions of pharmacist roles in the MUP.

DESIGN

This IRB-approved study used a cross-sectional design with online panels of patients, pharmacists, and physicians.

SETTING AND PARTICIPANTS

A Qualtrics panel of 1,004 patients, 205 pharmacists, and 200 physicians completed the surveys between August-November 2021.

OUTCOME MEASURES

Using role theory as framework, 12-item surveys were developed to examine perceptions regarding effectiveness of and best choice for improving each MUP step. Data analysis included descriptive statistics, correlations, and comparisons.

RESULTS

Majority of the physician, pharmacist, and patient samples believed that physicians prescribe the best possible medications (93.5%, 83.4%, 89.0% respectively), prescriptions are filled accurately (59.0%, 61.4%, 92.6% respectively) and timely (86.0%, 68.8, 90.2% respectively). Majority of physicians (78.5%) opined prescriptions are generally error free and patients are monitored (71%); fewer pharmacists agreed (42.9%, 51%; p<0.05). Most patients (92.4%) reported taking medications as directed; only 60% professionals agreed (p<0.05). Physicians selected 'pharmacists' as top choice for reducing dispensing errors, providing counseling, and helping patients take medications as directed. Patients wanted pharmacists to help manage their medications (87.0%) and 'someone' to periodically check on their health (100%). All 3 groups agreed physician-pharmacist collaboration was important to improve patient care and outcomes (90.0%-97.1%); however, 24% of physicians were uninterested in collaboration. Both professionals reported lack of time, appropriate setup, and interprofessional communication as challenges to collaboration.

CONCLUSION

Pharmacists believe their roles have evolved to align with expanded opportunities. Patients perceived pharmacists play comprehensive roles in medication management through counseling and monitoring. Physicians recognized pharmacist roles in dispensing and counseling, but not in prescribing or monitoring. Clarity in role expectations amongst these stakeholders is critical to optimizing pharmacist roles and patient outcomes.

摘要

目的

利益相关者对药剂师在药物使用过程(MUP)中的角色认知是否随着药剂师扩大的执业范围而演变尚不确定。本研究旨在调查患者、药剂师和医生对药剂师在MUP中角色的认知。

设计

这项经机构审查委员会批准的研究采用横断面设计,通过患者、药剂师和医生的在线小组进行。

设置和参与者

一个由1004名患者、205名药剂师和200名医生组成的Qualtrics小组在2021年8月至11月期间完成了调查。

结果指标

以角色理论为框架,开发了12项调查问卷,以调查对改善每个MUP步骤的有效性和最佳选择的认知。数据分析包括描述性统计、相关性分析和比较。

结果

大多数医生、药剂师和患者样本认为,医生开出的是尽可能最好的药物(分别为93.5%、83.4%、89.0%),处方配药准确(分别为59.0%、61.4%、92.6%)且及时(分别为86.0%、68.8%、90.2%)。大多数医生(78.5%)认为处方一般无差错,患者得到了监测(71%);同意的药剂师较少(42.9%、51%;p<0.05)。大多数患者(92.4%)报告按指示服药;只有60%的专业人员同意(p<0.05)。医生选择“药剂师”作为减少配药错误、提供咨询和帮助患者按指示服药的首选。患者希望药剂师帮助管理他们的药物(87.0%),并希望“有人”定期检查他们的健康状况(100%)。所有三组都认为医生与药剂师的合作对改善患者护理和治疗结果很重要(90.0%-97.1%);然而,24%的医生对合作不感兴趣。这两个专业群体都报告说,时间不足、设置不当和跨专业沟通是合作的挑战。

结论

药剂师认为他们的角色已经随着更多机会而演变。患者认为药剂师通过咨询和监测在药物管理中发挥全面作用。医生认可药剂师在配药和咨询方面,但在开处方或监测方面的角色。这些利益相关者之间角色期望的明确对于优化药剂师角色和患者治疗结果至关重要。

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