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加拿大纽芬兰和拉布拉多省 COVID-19 大流行关闭阶段的社区药剂师角色:定性案例研究。

Community pharmacists' roles during the closure stage of the COVID-19 pandemic in Newfoundland and Labrador, Canada: a qualitative case study.

机构信息

Pharmacy, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.

Faculty of Nursing, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.

出版信息

BMJ Open. 2024 Aug 5;14(8):e085338. doi: 10.1136/bmjopen-2024-085338.

Abstract

OBJECTIVES

To explore the experiences and perspectives of community pharmacists regarding their roles during the closure stage (ie, March to May 2020) of the COVID-19 pandemic in Newfoundland and Labrador (NL), Canada.

DESIGN

This qualitative case study included a document analysis and semistructured interviews with community pharmacists who provided direct patient care during the COVID-19 pandemic. The document analysis was used to develop a chronology that informed the interviews. Themes from qualitative interviews were developed through iterative cycles of data review and analysis using applied thematic analysis. Findings are presented specifically for the time period between March and May 2020, defined as the 'Closure Stage'.

SETTING

Community pharmacies in NL, Canada.

RESULTS

12 community pharmacists participated in the interviews. Four themes were developed including (1) pharmacists' leadership in continuity of care, (2) pharmacists as medication stewards, (3) pharmacists as a source of COVID-19 health information and (4) the impact of COVID-19 on pharmacists' mental health and well-being. The first three themes described the key roles played by community pharmacists during the early days of the COVID-19 pandemic, including coordinating care, prescribing for common ailments, delivering medications and supplies, providing information on COVID-19 symptoms and their management, renewing chronic medications and protecting the medication supply. Unclear guidance on scope of practice, limited scope of practice, inadequate staffing and limited support from government bodies were identified as barriers to these roles. Facilitators included access to a delivery service, swift regulatory changes, reimbursement and support from colleagues and other healthcare professionals. The fourth theme is presented independently, emphasising the impact of working within the primary healthcare (PHC) system during the COVID-19 pandemic on pharmacists' mental health and well-being.

CONCLUSION

Pharmacists played a critical role in the delivery of PHC services during the closure stage of the COVID-19 pandemic. The findings of this research highlight the essential elements of a strong PHC pandemic preparedness plan that is inclusive of community pharmacists, including improved communication strategies, mental health support and access to resources.

摘要

目的

探索加拿大纽芬兰和拉布拉多省(NL)社区药剂师在 COVID-19 大流行关闭阶段(即 2020 年 3 月至 5 月)期间对其角色的体验和看法。

设计

本定性案例研究包括对在 COVID-19 大流行期间直接为患者提供护理的社区药剂师进行文件分析和半结构化访谈。文件分析用于制定一个年表,为访谈提供信息。通过应用主题分析对定性访谈数据进行反复审查和分析,得出主题。研究结果专门针对 2020 年 3 月至 5 月期间(定义为“关闭阶段”)呈现。

地点

加拿大 NL 的社区药房。

结果

12 名社区药剂师参加了访谈。确定了四个主题,包括(1)药剂师在连续护理中的领导作用,(2)药剂师作为药物管理者,(3)药剂师作为 COVID-19 健康信息来源,(4)COVID-19 对药剂师心理健康和幸福感的影响。前三个主题描述了社区药剂师在 COVID-19 大流行早期扮演的关键角色,包括协调护理、治疗常见疾病、提供药物和用品、提供 COVID-19 症状及其管理、更新慢性病药物和保护药物供应。实践范围不明确、实践范围有限、人员不足以及政府机构的支持不足被确定为这些角色的障碍。促进因素包括获得交付服务、快速的监管变化、报销以及同事和其他医疗保健专业人员的支持。第四个主题是独立呈现的,强调了在 COVID-19 大流行期间在初级保健(PHC)系统内工作对药剂师心理健康和幸福感的影响。

结论

药剂师在 COVID-19 大流行关闭阶段在提供 PHC 服务方面发挥了关键作用。本研究的结果强调了包括社区药剂师在内的强大 PHC 大流行准备计划的基本要素,包括改进沟通策略、心理健康支持和获取资源。

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