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中国全科医生对与药剂师合作的态度和频率:一项横断面研究。

General practitioners' attitudes towards and frequency of collaboration with pharmacists in China: a cross-sectional study.

机构信息

Department of General Practice, The Second Affiliated Hospital, School of Medicine, The Chinese University of Hong Kong, Shenzhen & Longgang District People's Hospital of Shenzhen, Shenzhen, 518172, China.

Xinsheng Community Health Service Center, Shenzhen Longgang Central Hospital, Shenzhen, 518116, China.

出版信息

BMC Health Serv Res. 2023 Oct 27;23(1):1174. doi: 10.1186/s12913-023-10151-0.

Abstract

BACKGROUND

Building interprofessional working relationships between general practitioners (GPs) and pharmacists is essential to ensure high-quality patient care. However, there is limited Chinese literature on GP-pharmacist collaboration, and few studies have explored GPs' experiences with pharmacist integration into general practices. This study aimed to investigate GPs' attitudes towards and frequency of collaboration with pharmacists in China.

METHODS

This cross-sectional study used an online self-administered questionnaire integrating two scales, ATCI-GP and FICI-GP, which had been translated and validated to investigate 3,248 GPs from February 15 to March 15, 2023 across Zhejiang Province, China. Descriptive analyses were used, and the factors associated with GPs' frequency of collaboration with pharmacists were explored using logistic regression analysis.

RESULTS

A total of 2,487 GPs (76.6%) responded and consented to participate in the survey; 52.3% were male and the mean age was 35.4 years. Most GPs agreed that they shared common goals and objectives with pharmacists when caring for patients (90.0%), and pharmacists were open to working with them on patients' medication management (80.8%). However, half of the GPs did not change or seldom changed the patient's medication on the pharmacist's advice (51.4%). Logistic regression analysis showed that GPs who were older and had more years of practice were more likely to agree that pharmacists were willing to collaborate, had common goals for treatment and that they would change the patient's medication on the advice of the pharmacist. GPs who had regular communication protocols (adjusted odds ratio [aOR] = 1.88, 95% CI 1.45-2.45; aOR = 3.33, 95% CI 2.76-4.02), participated in joint continuing education (aOR = 1.87, 95% CI 1.44-2.43; aOR = 2.27, 95% CI 1.91-2.70), provided recommendations for medication review (aOR = 3.01, 95% CI 2.07-4.38; aOR = 3.50, 95% CI 2.51-4.86), and communicated with pharmacists during resident training (aOR = 2.15, 95% CI 1.78-2.60; aOR = 1.38, 95% CI 1.18-1.62) were associated with a more positive attitude towards and higher frequency of cooperation.

CONCLUSIONS

GPs in China displayed a positive attitude towards cooperating with pharmacists, but they did not demonstrate a similar level of practice. As environmental determinants impact interdisciplinary collaboration, healthcare managers and policy-makers need to implement measures that foster a supportive environment conducive to interdisciplinary collaboration.

摘要

背景

建立全科医生与药剂师之间的跨专业工作关系对于确保高质量的患者护理至关重要。然而,中文文献中关于全科医生-药剂师合作的内容有限,很少有研究探讨全科医生对药剂师融入全科实践的体验。本研究旨在调查中国全科医生对与药剂师合作的态度和合作频率。

方法

本横断面研究使用在线自我管理问卷,整合了两个量表,即 ATCI-GP 和 FICI-GP,这两个量表已经过翻译和验证,用于调查 2023 年 2 月 15 日至 3 月 15 日期间来自中国浙江省的 3248 名全科医生。使用描述性分析,并使用逻辑回归分析探讨与药剂师合作频率相关的因素。

结果

共有 2487 名(76.6%)全科医生对调查做出回应并同意参与;52.3%为男性,平均年龄为 35.4 岁。大多数全科医生同意,在照顾患者时,他们与药剂师有共同的目标(90.0%),药剂师愿意与他们一起管理患者的药物(80.8%)。然而,有一半的全科医生在药剂师的建议下没有改变或很少改变患者的药物(51.4%)。逻辑回归分析表明,年龄较大和从业年限较长的全科医生更有可能同意药剂师愿意合作、对治疗有共同目标以及根据药剂师的建议改变患者的药物。有定期沟通协议(调整后的优势比 [aOR] = 1.88,95%置信区间 1.45-2.45;aOR = 3.33,95%置信区间 2.76-4.02)、参加联合继续教育(aOR = 1.87,95%置信区间 1.44-2.43;aOR = 2.27,95%置信区间 1.91-2.70)、提供药物审查建议(aOR = 3.01,95%置信区间 2.07-4.38;aOR = 3.50,95%置信区间 2.51-4.86)和在住院医师培训期间与药剂师沟通(aOR = 2.15,95%置信区间 1.78-2.60;aOR = 1.38,95%置信区间 1.18-1.62)的全科医生对合作持更积极的态度和更高的合作频率。

结论

中国的全科医生对与药剂师合作持积极态度,但实践水平并不一致。由于环境决定因素会影响跨学科合作,医疗保健管理人员和政策制定者需要实施措施,营造有利于跨学科合作的支持性环境。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f67e/10612245/126e1cfc4b31/12913_2023_10151_Fig1_HTML.jpg

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