Wells C Julie, McBain Lynn, Gray Lesley
Department of Primary Health Care & General Practice, University of Otago Wellington, 23a Mein Street, Wellington 6242, New Zealand; and 420 Mangawhero Road, RD7, Whanganui, New Zealand.
Department of Primary Health Care & General Practice, University of Otago Wellington, 23a Mein Street, Wellington 6242, New Zealand.
J Prim Health Care. 2024 Dec;16(4):364-371. doi: 10.1071/HC24034.
Introduction Continuity of care is considered vital to achieving high-quality health care. Traditionally, general practitioners have played a key role in managing continuity of care and have largely been accountable for prescribing decision-making in primary care. Following prescribing legislation changes, a range of health disciplines make decisions regarding medicines in the general practice setting. To date, few studies have investigated how different prescribing disciplines view the management of medicines-related continuity of care. Understanding the views of these clinicians is important to achieving safe, effective and equitable outcomes from medicines. Aim The purpose of this study was to explore the views of general practitioners, nurse prescribers and pharmacist prescribers about their role in managing medicines-related continuity of care. Methods Qualitative, semi-structured in-depth interviews were undertaken with 16 prescribers based in eight North Island (New Zealand) general practices. Interviews were transcribed verbatim and analysed thematically using an inductive approach. Results Three key themes were identified from data analysis: a patient-focused approach; interdisciplinary teamwork; and optimising the medicine regimen. Discussion Prescribers in this study identify the important connection between continuity of care and achieving good outcomes from medicines. Good patient-prescriber relationships and ongoing interdisciplinary relationships across all health settings are considered essential to medicines-related continuity of care. Prescribers experience challenges associated with increasing multimorbidity, medicines complexities and fragmentation of clinical records.
引言 连续性护理对于实现高质量医疗保健至关重要。传统上,全科医生在管理连续性护理方面发挥着关键作用,并且在很大程度上对初级保健中的处方决策负责。随着处方立法的变化,一系列健康学科在全科医疗环境中就药物做出决策。迄今为止,很少有研究调查不同的处方学科如何看待与药物相关的连续性护理管理。了解这些临床医生的观点对于实现安全、有效和公平的药物治疗结果很重要。目的 本研究的目的是探讨全科医生、护士处方者和药剂师处方者对他们在管理与药物相关的连续性护理中的作用的看法。方法 对新西兰北岛8家全科诊所的16名处方者进行了定性、半结构化深度访谈。访谈逐字记录,并采用归纳法进行主题分析。结果 数据分析确定了三个关键主题:以患者为中心的方法;跨学科团队合作;以及优化药物治疗方案。讨论 本研究中的处方者认识到连续性护理与实现良好药物治疗结果之间的重要联系。良好的患者与处方者关系以及所有健康环境中持续的跨学科关系被认为是与药物相关的连续性护理的关键。处方者面临着与日益增加的多种疾病、药物复杂性和临床记录碎片化相关的挑战。