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西班牙社区药房与初级保健整合的战略干预措施及新模式:定性见解

Strategic interventions and a novel model for the integration of community pharmacy and primary care in Spain: qualitative insights.

作者信息

Piquer-Martinez Celia, Urionagüena Amaia, Benrimoj Shalom I, Calvo Begoña, García-Cárdenas Victoria, Amador-Fernandez Noelia, Gastelurrutia Miguel A, Martinez Martinez Fernando

机构信息

Pharmaceutical Care Research Group, University of Granada Faculty of Pharmacy, Granada, Spain

Pharmacy Practice Research Group, University of the Basque Country Faculty of Pharmacy, Vitoria-Gasteiz, Basque Country, Spain.

出版信息

BMJ Open. 2024 Dec 27;14(12):e086285. doi: 10.1136/bmjopen-2024-086285.

Abstract

OBJECTIVES

To explore the opinions and perceptions of key stakeholders on the integration between community pharmacy and primary care, within the Valencian Autonomous Community. Specific objectives include identifying strategic interventions to facilitate this integration. Additionally, the manuscript discusses the formulation of a novel model for the integration of community pharmacy and primary care.

DESIGN

Qualitative, with data from five virtual focus groups (FG) and 12 semistructured interviews analysed thematically using NVivo and interventions prioritised through a virtual nominal group technique.

SETTING

Valencian Autonomous Community (Spain).

PARTICIPANTS

FG involved community pharmacists (CP) and primary care stakeholders including general practitioners, primary care nurses, general practitioner pharmacists, social services managers and administrators. Interviewees were government representatives and professionals from organisations. Selection was through snowball sampling and invitations by Official Colleges of Pharmacists.

RESULTS

Five themes emerged, revealing the multifaceted nature of integrating community pharmacies and primary care. 'Integration' was identified as an ambitious target, anchored in collaboration and communication efforts. The role of CP was particularly noted for their direct patient interaction and trust, vital in fostering medication adherence. Barriers like role ambiguity and regulatory environment were highlighted. Seven interventions were identified to enable integration, with three of them prioritised: 'bidirectional communication', 'protocol standardisation' and 'multidisciplinary team strengthening'. These interventions, linked with prior components of health system integration, led to a pioneer integration model.

CONCLUSIONS

Recognising stakeholder insights is essential in shaping workable, practical and adaptable models for integration. Tailoring these temporal models to stakeholders' immediate needs and strategic priorities may serve as effective starting points for integration. Support from professional bodies and proactive stakeholders' engagement will optimise the integration success and its acceptance across healthcare levels.

摘要

目的

探讨巴伦西亚自治区关键利益相关者对社区药房与初级保健整合的意见和看法。具体目标包括确定促进这种整合的战略干预措施。此外,本文还讨论了社区药房与初级保健整合的新型模式的制定。

设计

定性研究,来自五个虚拟焦点小组(FG)的数据和12次半结构化访谈采用NVivo进行主题分析,并通过虚拟名义小组技术对干预措施进行优先排序。

背景

巴伦西亚自治区(西班牙)。

参与者

焦点小组包括社区药剂师(CP)和初级保健利益相关者,包括全科医生、初级保健护士、全科医生药剂师、社会服务经理和管理人员。受访者是政府代表和各组织的专业人员。通过滚雪球抽样和药剂师官方学院的邀请进行选择。

结果

出现了五个主题,揭示了社区药房与初级保健整合的多方面性质。“整合”被确定为一个宏伟目标,基于协作和沟通努力。特别提到了社区药剂师的作用,因为他们与患者直接互动且受患者信任,这对促进药物依从性至关重要。强调了角色模糊和监管环境等障碍。确定了七项促进整合的干预措施,其中三项被列为优先措施:“双向沟通”、“协议标准化”和“加强多学科团队”。这些干预措施与卫生系统整合的先前要素相关联,形成了一个开创性的整合模式。

结论

认识到利益相关者的见解对于塑造可行、实用和适应性强的整合模式至关重要。根据利益相关者的当前需求和战略重点调整这些临时模式,可能是整合的有效起点。专业机构的支持和积极的利益相关者参与将优化整合的成功及其在各级医疗保健中的接受度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9097/11684000/a4a6d928dc0e/bmjopen-14-12-g001.jpg

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