Officer Tara, McDonald Janet, Jeffreys Mona, Cumming Jacqueline, Russell Lynne, McKinlay Eileen, Kennedy Jonathan, Tanuvasa Ausaga Fa'asalele, Morris Caroline
Te Kura Tapuhi Hauora School of Nursing, Midwifery, and Health Practice, Te Herenga Waka-Victoria University of Wellington, PO Box 600, Wellington, 6140, New Zealand.
Te Hikuwai Rangahau Hauora-Health Services Research Centre, Te Herenga Waka-Victoria University of Wellington, PO Box 600, Wellington, 6140, New Zealand.
BMC Health Serv Res. 2024 Dec 18;24(1):1571. doi: 10.1186/s12913-024-11948-3.
Recognition is growing of the contributions community pharmacists make to the primary health care team, as their role shifts from a traditional dispensing focus to greater emphasis on fully applying their clinical skills. Some extended pharmacist services (e.g., vaccinations) are becoming increasingly common in New Zealand (Aotearoa). Community pharmacies provided key services during the COVID-19 response.
An online survey was sent to community and intern pharmacists in 2022, regarding delivery of extended services and enablers and barriers to service provision, to look at changes since a 2018 survey. New questions were included regarding pharmacy services during the COVID-19 pandemic. Descriptive analyses were conducted, and comparisons made between reported proportions in the 2018 and 2022 surveys. For questions related to attributes of pharmacies rather than pharmacists, we weighted the data by the inverse of the number of pharmacists in the pharmacy.
A total of 64 pharmacists and 25 interns responded to the survey. The most common services for which pharmacists were accredited were the provision of the emergency contraceptive pill (95%), sildenafil (94%), trimethoprim (88%) and immunisations (80%). There was an increase from 2018 to 2022 in the proportion of pharmacists who were accredited to provide selected oral contraceptives and immunisations. As in 2018, interns showed strong interest in gaining accreditation for all extended services. Enablers and barriers to offering extended services did not change materially between 2018 and 2022, other than a greater proportion of pharmacists reporting that they were too busy dispensing to offer more services (an increase from 46 to 63%, P = 0.033). Almost all (98%) reported that "COVID increased the levels of stress at work", 94% that "workload has increased", and 90% that "home delivery services increased." Sixty-nine percent of pharmacists and 73% of interns reported work stress negatively affecting their wellbeing.
Most pharmacists want to work at the top of their scope of practice and are accredited to offer a range of extended services. However, their ability to focus on more patient-facing roles continues to be constrained by the time they spend dispensing. Adequate remuneration for services provided remains a concern.
随着社区药剂师的角色从传统的配药重点转向更加强调充分运用其临床技能，人们越来越认识到他们对初级卫生保健团队的贡献。在新西兰（奥特亚罗瓦），一些扩展的药剂师服务（如疫苗接种）正变得越来越普遍。社区药房在应对新冠疫情期间提供了关键服务。
2022年，针对社区药剂师和实习药剂师开展了一项在线调查，内容涉及扩展服务的提供以及服务提供的促进因素和障碍，以了解自2018年调查以来的变化。新增了关于新冠疫情期间药房服务的问题。进行了描述性分析，并对2018年和2022年调查中报告的比例进行了比较。对于与药房而非药剂师属性相关的问题，我们以药房药剂师数量的倒数对数据进行加权。
共有64名药剂师和25名实习生回复了调查。药剂师获得认可的最常见服务是提供紧急避孕药（95%）、西地那非（94%）、甲氧苄啶（88%）和免疫接种（80%）。从2018年到2022年，获得认可提供特定口服避孕药和免疫接种的药剂师比例有所增加。与2018年一样，实习生对获得所有扩展服务的认可表现出浓厚兴趣。2018年至2022年期间，提供扩展服务的促进因素和障碍没有实质性变化，只是报告称太忙无法配药而无法提供更多服务的药剂师比例有所增加（从46%增至63%，P = 0.033）。几乎所有（98%）报告称“新冠增加了工作压力水平”，94%称“工作量增加”，90%称“送货上门服务增加”。69%的药剂师和73%的实习生报告工作压力对他们的幸福感产生了负面影响。
大多数药剂师希望在其执业范围内充分发挥作用，并获得认可提供一系列扩展服务。然而，他们专注于更多面向患者角色的能力仍然受到配药时间的限制。所提供服务的适当报酬仍然是一个问题。
