卡塔尔社区药剂师为老年人停用不适当药物的准备工作的促进因素和障碍。
Enablers and barriers to community pharmacists' readiness to implement deprescribing of inappropriate medications for older adults in Qatar.
作者信息
Elshazly Marwa, Jawad Sondus, Ahmed Ayesha, ElGeed Hager, Yusuff Kazeem Babatunde
机构信息
Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar.
出版信息
PLoS One. 2025 Jan 30;20(1):e0316363. doi: 10.1371/journal.pone.0316363. eCollection 2025.
There is paucity of studies focused on the enablers and barriers to community pharmacists' readiness to deprescribe inappropriate medications for older adults in developing settings. The current study assessed the enablers and barriers to community pharmacists' readiness to implement deprescribing of inappropriate medications for older adults. A cross-sectional survey of 252 community pharmacists was conducted in Qatar with a pre-tested 24-item questionnaire developed with the theory of domain framework. Information about perceived enablers and barriers were elicited with a 5-point Likert-type scale. The response rate was 79.4% (200/252). The majority of the community pharmacists were females (54.5%), within the age range of 20-40 years (88.0%), had BSc / BPharm as the highest educational qualification (70.5%), were full-time employee (97.0%). The top-ranked enablers of community pharmacists' readiness to implement deprescribing were exposure to CPD on the use of deprescribing toolkits and algorithm (66%), interprofessional collaboration with physicians (60.5%) and shared electronic patient record (59.5%), and improved remuneration / re-imbursement 58%). The top-ranked barriers were lack of access to patient records (70.5%), ineffective collaboration with physicians (66.5%), lack of time due to heavy workload (65%), regulatory framework that limit expansion of clinical roles (51%) and intense focus on sales target (49%). The top-ranked enablers of community pharmacists' readiness to implement deprescribing were exposure to CPD on the use of deprescribing toolkits and algorithm, interprofessional collaboration with physicians and shared electronic patient record. These findings bode well for the implementation of community pharmacists-led deprescribing of inappropriate medications for older adults in Qatar. However, a number of critical barriers were identified, and these will require institutional, regulatory and organizational interventions to improve readiness.
在发展中环境下，针对社区药剂师为老年人停用不适当药物的促成因素和障碍的研究较少。本研究评估了社区药剂师为老年人停用不适当药物的促成因素和障碍。在卡塔尔对252名社区药剂师进行了横断面调查，使用基于领域框架理论编制并预先测试的24项问卷。通过5点李克特量表收集有关感知到的促成因素和障碍的信息。回复率为79.4%（200/252）。大多数社区药剂师为女性（54.5%），年龄在20 - 40岁之间（88.0%），最高学历为理学学士/药学学士（70.5%），是全职员工（97.0%）。社区药剂师准备实施停用药物的排名靠前的促成因素是接触关于使用停用药物工具包和算法的持续专业发展（CPD）（66%）、与医生的跨专业协作（60.5%）和共享电子病历（59.5%），以及提高薪酬/报销（58%）。排名靠前的障碍是无法获取患者记录（70.5%）、与医生的协作无效（66.5%）、由于工作量大而缺乏时间（65%）、限制临床角色扩展的监管框架（51%）和对销售目标的过度关注（49%）。社区药剂师准备实施停用药物的排名靠前的促成因素是接触关于使用停用药物工具包和算法的CPD、与医生的跨专业协作和共享电子病历。这些发现对于在卡塔尔实施由社区药剂师主导的为老年人停用不适当药物的工作来说是个好兆头。然而，也发现了一些关键障碍，这需要机构、监管和组织层面的干预来提高准备程度。
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