Dahri Karen, Sinclair Formerly MacNeil Kimberley, Piszczek Jolanta, Wilbur Kerry, Wong Bryce, Kuo I Fan, Marra Fawziah
Vancouver General Hospital, Vancouver, BC.
Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC.
Can Pharm J (Ott). 2024 Nov 15;158(1):55-65. doi: 10.1177/17151635241288577. eCollection 2025 Jan-Feb.
In February 2022, a novel antiviral for the treatment of COVID-19, nirmatrelvir/ritonavir (Paxlovid), was approved by Health Canada and made available to patients in British Columbia (BC). BC community pharmacists did not prescribe nirmatrelvir/ritonavir, but dispensing involved a detailed assessment with close attention to drug-drug interactions and patient monitoring. As the nirmatrelvir/ritonavir service was unique in BC, and not all pharmacists participated in the program, it is important to evaluate the perspectives of all the pharmacists who were affected so that lessons learned from the program can inform future pandemic planning and government initiatives.
A qualitative research study using key informant semistructured interviews was conducted. Community pharmacists with varying degrees of experience with nirmatrelvir/ritonavir were recruited using multiple methods of recruitment through e-mail and fax invitations and social media posts. Open-ended questions explored pharmacists' experiences with the nirmatrelvir/ritonavir program, including barriers and facilitators to dispensing it, and recommendations for future pharmacy initiatives.
Forty-three community pharmacists participated in the study. Most participants were between the ages of 30 and 39 years and had practiced for less than 10 years. Thematic analysis yielded 36 codes that were organized into 3 overarching themes related to the following: learning; in-process experiences, supports, difficulties; and perceptions about the expanded scope of practice.
The following strategies may be helpful to consider including in future initiatives: preprinted forms, a hotline for peer support, slower rollouts, a single source for communicating changes, a patient portal, addressing the divisions between dispensary and clinical work, and having specialized positions to support future rollouts.
Lessons learned from the nirmatrelvir/ritonavir service included a slower approach to program initiation with additional training opportunities and more streamlined prescription options. Pharmacists also wished for better communication support and involvement in the planning of future initiatives.
2022年2月，一种用于治疗新冠肺炎的新型抗病毒药物奈玛特韦/利托那韦（帕罗韦德）获加拿大卫生部批准，并可供不列颠哥伦比亚省（BC省）的患者使用。BC省的社区药剂师不开具奈玛特韦/利托那韦的处方，但配药过程涉及详细评估，需密切关注药物相互作用和患者监测情况。由于奈玛特韦/利托那韦服务在BC省独具特色，且并非所有药剂师都参与该项目，因此评估所有受影响药剂师的观点非常重要，以便从该项目中吸取的经验教训能为未来的疫情应对规划和政府举措提供参考。
开展了一项采用关键信息人半结构化访谈的定性研究。通过电子邮件、传真邀请以及社交媒体帖子等多种招募方式，招募了对奈玛特韦/利托那韦有不同程度经验的社区药剂师。开放式问题探讨了药剂师在奈玛特韦/利托那韦项目中的经历，包括配药的障碍和促进因素，以及对未来药房举措的建议。
43名社区药剂师参与了该研究。大多数参与者年龄在30至39岁之间，从业时间不到10年。主题分析得出36个编码，这些编码被归纳为3个总体主题，分别与以下方面相关：学习；过程中的经历、支持和困难；以及对扩大执业范围的看法。
以下策略可能有助于在未来举措中考虑采用：预印表格、同行支持热线、更缓慢的推广、传达变更的单一来源、患者门户、解决药房工作与临床工作之间的分歧，以及设立专门职位以支持未来的推广。
从奈玛特韦/利托那韦服务中吸取的经验教训包括采用更缓慢的项目启动方式，提供更多培训机会以及更简化的处方选择。药剂师还希望获得更好的沟通支持，并参与未来举措的规划。
