Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, Indonesia.
Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang, Indonesia.
Front Public Health. 2023 Jul 17;11:1213520. doi: 10.3389/fpubh.2023.1213520. eCollection 2023.
The use of medication therapy management (MTM) is a proven method for reducing medication errors. MTM services rely heavily on pharmacists as service providers, particularly in community health centers (CHCs). Thus, understanding the knowledge, attitudes, and practices (KAP) of MTM among pharmacists in CHCs is crucial to the strategy for the implementation of MTM program in Indonesia. This study aimed to assess the level of KAP regarding MTM among pharmacists working at CHCs and its associated factors and investigate pharmacists' perceptions of the barriers and facilitators of MTM provision in the future.
A cross-sectional online survey was conducted. The respondents were pharmacists working at CHCs in 28 provinces in Indonesia. Descriptive statistics were used to summarize the responses. Demographic differences were determined using Chi-square and Kruskal-Wallis tests, and associations were identified using multivariable ordinal regression for knowledge and multivariable logistic regression for attitude and practice. Barriers and facilitators were determined from codes and categories of frequency derived from pharmacists' responses to the open-ended questions.
Of the 1,132 pharmacists, 74.9% had a high level of knowledge, 53.6% had a positive attitude, and 57.9% had a positive practice toward MTM. Gender, practice settings, province of CHCs, years of practice, and experience in MTM services were factors associated with the KAP level. Respondents perceived that the chronic disease conditions in Indonesia, MTM service features, and current practices were facilitators of MTM provision. The lack of interprofessional collaboration, staff, pharmacist knowledge, patient cooperation, facilities/drug supply/documentation systems, stakeholder support, and patient compliance were the most common barriers to MTM implementation in the future.
Most of the pharmacists had high knowledge of MTM; however, only half had positive attitudes and practices toward MTM. Information about factors associated with the KAP level suggests that direct involvement is essential to improve pharmacists' understanding and view of MTM. Pharmacists also perceived barriers to the MTM provision in the future, such as interprofessional and pharmacist-patient relationships. A training program is needed to improve the KAP of MTM and develop skills for collaborating with other healthcare professionals and communicating with patients.
药物治疗管理（MTM）的使用是减少用药错误的一种经过验证的方法。MTM 服务严重依赖药剂师作为服务提供者，特别是在社区卫生中心（CHC）。因此，了解 CHC 药剂师在 MTM 方面的知识、态度和实践（KAP）对于印度尼西亚实施 MTM 计划的策略至关重要。本研究旨在评估 CHC 药剂师在 MTM 方面的 KAP 水平及其相关因素，并调查药剂师对未来 MTM 提供的障碍和促进因素的看法。
采用横断面在线调查。受访者为印度尼西亚 28 个省的 CHC 药剂师。使用描述性统计来总结回应。使用卡方检验和克鲁斯卡尔-沃利斯检验确定人口统计学差异，使用多变量有序回归确定知识关联，使用多变量逻辑回归确定态度和实践关联。从药剂师对开放式问题的回答中得出的代码和类别确定障碍和促进因素。
在 1132 名药剂师中，74.9%具有较高的知识水平，53.6%具有积极的态度，57.9%对 MTM 具有积极的实践。性别、实践环境、CHC 所在省份、从业年限和 MTM 服务经验是 KAP 水平相关的因素。受访者认为印度尼西亚的慢性病状况、MTM 服务特点和当前实践是 MTM 提供的促进因素。缺乏跨专业合作、人员、药剂师知识、患者合作、设施/药物供应/文件系统、利益相关者支持和患者依从性是未来 MTM 实施的最常见障碍。
大多数药剂师对 MTM 有较高的了解；然而，只有一半对 MTM 有积极的态度和实践。与 KAP 水平相关的因素表明，直接参与对于提高药剂师对 MTM 的理解和看法至关重要。药剂师还认为未来 MTM 提供存在障碍，例如跨专业和药剂师-患者关系。需要开展培训计划，以提高 MTM 的 KAP 并培养与其他医疗保健专业人员合作和与患者沟通的技能。
