Clinical Pharmacy Department, Institute of Pharmacy, Medical Faculty, Leipzig University, Bruederstrasse 32, 04103, Leipzig, Germany.
Drug Safety Center, Leipzig University and Leipzig University Hospital, Bruederstraße 32, 04103, Leipzig, Germany.
Int J Clin Pharm. 2024 Dec;46(6):1500-1513. doi: 10.1007/s11096-024-01797-9. Epub 2024 Sep 6.
Community pharmacy practice is rarely considered in ethical research, although various ethical conflicts are known for this setting. Data on the actual frequency and perceived burden of ethical conflicts occurring in the community pharmacy setting are required.
The survey aimed at investigating the frequency and perceived burden of ethical conflicts, reasons for the perceived burden and influences on decision-making in ethical conflicts in German community pharmacists.
An online survey was conducted among community pharmacists. It contained 15 ethical conflicts in which the ethically required action conflicts with another principle (e.g. law). Basing on these conflicting principles, 12 considerations relevant for decision-making were defined (e.g. solidarity principle). Participants were asked to rate the ethical conflicts in terms of frequency and perceived burden and to rate the influence on decision-making for the considerations. Results were analysed descriptively.
Five hundred and thirty-five questionnaires were evaluated. The participant's median age was 39 (min-max: 20-78) years, 378 (71%) were female. Seven of the 15 predefined ethical conflicts were rated as occurring predominantly at least once a week. "Generic drug is not most suitable" was rated as the most frequent. Three ethical conflicts were rated mainly with a (very) strong burden. "Concerns for an unborn child" was rated as the most burdensome. Three of the 12 predefined decision-making considerations: pharmaceutical knowledge, legal requirements and personal values were rated primarily as having a very strong influence on decision-making.
Pharmacists in community pharmacies are frequently affected by burdensome ethical conflicts in patient care situations.
社区药房实践在伦理研究中很少被考虑，尽管这个环境中存在各种伦理冲突。需要了解社区药房环境中实际发生的伦理冲突的频率和感知负担，以及导致这些冲突的原因和对决策的影响。
本调查旨在调查德国社区药剂师在社区药房中发生的伦理冲突的频率和感知负担、感知负担的原因以及对伦理冲突决策的影响。
对社区药剂师进行了在线调查。它包含了 15 种伦理冲突，其中伦理要求的行动与另一个原则（例如法律）相冲突。基于这些冲突的原则，定义了 12 个与决策相关的考虑因素（例如团结原则）。要求参与者根据频率和感知负担对伦理冲突进行评分，并对考虑因素对决策的影响进行评分。结果进行了描述性分析。
评估了 535 份问卷。参与者的中位数年龄为 39 岁（最小-最大：20-78 岁），其中 378 名（71%）为女性。15 个预设的伦理冲突中有 7 个被评定为至少每周发生一次。“非专利药物不是最合适的”被评为最频繁的。有 3 个伦理冲突被评为主要有（非常）强烈的负担。“对未出生孩子的担忧”被评为最具负担的。12 个预设决策考虑因素中的 3 个：药学知识、法律要求和个人价值观被评为对决策有非常强烈的影响。
社区药房的药剂师在患者护理情况下经常受到负担沉重的伦理冲突的影响。
