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药剂师在药物使用过程中的角色:利益相关者认知的定性分析。

Pharmacist roles in the Medication Use Process: Qualitative analysis of stakeholder perceptions.

出版信息

J Am Pharm Assoc (2003). 2024 Nov-Dec;64(6):102186. doi: 10.1016/j.japh.2024.102186. Epub 2024 Sep 13.

Abstract

BACKGROUND

Pharmacist roles in the Medication Use Process (MUP) have advanced along with new healthcare delivery models and interprofessional collaborative practice. It is unclear whether stakeholder perceptions of pharmacist roles have evolved simultaneously.

OBJECTIVES

Examine patient, pharmacist, and physician perceptions of pharmacist roles in the MUP.

METHODS

This institutional review board-approved study used a cross-sectional design with Qualtrics panels of patients, pharmacists, and physicians. Role Theory was used as a framework to develop 12-item surveys to study pharmacist role perceptions in the MUP: prescribing, transcribing, dispensing, administration, and monitoring. Content analysis was performed on the responses to open-ended questions.

RESULTS

From 1004 patients, a total of 7217 comments were obtained on 9 questions (740-1004 comments), resulting in an average of 802 comments per question or 0.8 comments per question per respondent (CQR). Similarly, 1620 comments from 205 pharmacists on 11 questions (121-205 comments) averaged 0.72 CQR; and 1561 comments from 200 physicians on 11 questions (136-200 comments) equated to 0.74 CQR. Content analysis revealed recurring themes across the stakeholders: "pharmacists," "physicians," "insurance," "technology," "collaboration," "time," "communication," and "patient's responsibility." Some role congruence was seen regarding pharmacist roles by all 3 stakeholders; noting pharmacist roles in improving all steps of the MUP, except transcribing. Pharmacists highlighted professional challenges such as staffing issues, burnout, and competing demands; which were not acknowledged by patients and physicians indicating the need to increase awareness.

CONCLUSION

This study showed increased visibility and awareness of pharmacist roles in the MUP by all stakeholders, compared to previous research showing pharmacist roles limited to dispensing. Known barriers to pharmacy practice such as lack of provider status and reimbursement were not reported by any of the stakeholders in this study. There is a need to continuously inform stakeholders about pharmacists' expanding roles in the MUP through advocacy and marketing.

摘要

背景

随着新的医疗保健提供模式和跨专业协作实践的发展,药剂师在用药过程(MUP)中的角色也在不断发展。目前尚不清楚利益相关者对药剂师角色的看法是否同时发生了变化。

目的

考察患者、药剂师和医生对药剂师在 MUP 中角色的看法。

方法

本研究经机构审查委员会批准,采用横断面设计,利用患者、药剂师和医生的 Qualtrics 小组。角色理论被用作一个框架,开发了 12 项调查来研究 MUP 中药剂师角色的看法:处方、转录、配药、给药和监测。对开放式问题的回答进行了内容分析。

结果

从 1004 名患者中,共获得了 9 个问题的 7217 条评论(740-1004 条评论),每个问题平均有 802 条评论或每个问题每个回答者 0.8 条评论(CQR)。同样,205 名药剂师对 11 个问题的 1620 条评论(121-205 条评论)平均为 0.72 CQR;200 名医生对 11 个问题的 1561 条评论(136-200 条评论)相当于 0.74 CQR。内容分析揭示了利益相关者之间反复出现的主题:“药剂师”、“医生”、“保险”、“技术”、“协作”、“时间”、“沟通”和“患者的责任”。所有 3 个利益相关者都认为药剂师在改善 MUP 的所有步骤中扮演着角色,除了转录。药剂师强调了专业挑战,如人员配备问题、倦怠和竞争需求;而患者和医生则没有注意到这些问题,这表明需要提高认识。

结论

与之前研究表明药剂师的角色仅限于配药相比,本研究表明,所有利益相关者对药剂师在 MUP 中的角色的可见度和认识都有所提高。本研究没有任何利益相关者报告药学实践中已知的障碍,如缺乏提供者地位和报销。需要通过宣传和营销不断向利益相关者告知药剂师在 MUP 中不断扩大的角色。

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