Corvaisier Mathieu, Come Lucile, Boughammoura Housni, Annweiler Cédric, Spiesser-Robelet Laurence
UNIV ANGERS, School of Pharmacy, Health Faculty, University of Angers, 49045, Angers, France.
UNIV ANGERS, EA4638, University of Angers, 49100, Angers, France.
Int J Clin Pharm. 2024 Dec 31. doi: 10.1007/s11096-024-01856-1.
The management of psychotropic medication in older adults is a challenge for every healthcare professional, but data concerning community pharmacists are scarce in the literature.
Our objectives were i) to understand the difficulties encountered by community pharmacists in managing older adults on psychotropic medication, and ii) to identify potential solutions to the difficulties discussed.
A qualitative study by focus group was proposed to all community pharmacists in the vicinity of the university hospital of Angers, France, between May and June 2023. An interview guide was established based on data from literature, with open-ended questions covering 5 categories: management of adverse drug reactions, patient counselling and dispensing, management of psychotropic misuse, pharmacological knowledge, professional relationship and communication. Data were analysed using thematic analysis with an inductive approach.
Four consecutive focus groups were conducted with 17 community pharmacists. Three themes emerged from the various discussions: communication-related issues (e.g. patients refusing to discuss or consider the pharmacist's advice, lack of care-continuity between hospital and community pharmacy); system-related issues (e.g. limitation of time available for patient counselling, lack of access to the patient's clinical details); and psychotropic-related issues (e.g. different perceptions of the risk-benefit ratio between patients and pharmacists, suspected dependence leading to overuse).
The challenges of managing psychotropic medications in older people in community pharmacies are many, but there are solutions. They mainly revolve around interprofessional collaboration, improving the patient pathway, particularly the link between hospital and community pharmacy, and improving training for pharmacists in optimising psychotropic medication.
老年患者精神药物的管理对每位医疗保健专业人员来说都是一项挑战，但文献中关于社区药剂师的数据却很匮乏。
我们的目标是：（i）了解社区药剂师在管理服用精神药物的老年人时遇到的困难；（ii）确定针对所讨论困难的潜在解决方案。
2023年5月至6月期间，向法国昂热大学医院附近的所有社区药剂师提出了一项焦点小组定性研究。根据文献数据制定了一份访谈指南，其中包括开放式问题，涵盖5个类别：药物不良反应的管理、患者咨询与配药、精神药物滥用的管理、药理知识、专业关系与沟通。采用归纳法进行主题分析来分析数据。
对17名社区药剂师进行了连续4次焦点小组讨论。从各种讨论中出现了三个主题：与沟通相关的问题（例如患者拒绝讨论或考虑药剂师的建议、医院与社区药房之间缺乏护理连续性）；与系统相关的问题（例如用于患者咨询的时间有限、无法获取患者的临床详细信息）；以及与精神药物相关的问题（例如患者与药剂师对风险效益比的不同看法、疑似依赖导致药物过度使用）。
社区药房管理老年人精神药物面临诸多挑战，但也有解决办法。它们主要围绕跨专业协作、改善患者就医流程，尤其是医院与社区药房之间的联系，以及加强药剂师在优化精神药物方面的培训。
