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中国深圳医院药师融入基层医疗服务的质性研究

The integration of hospital pharmacists into primary care settings in Shenzhen, China: a qualitative study.

作者信息

Deng Zhiling, Zhou Pengxiang, Lu Yiting, Li Zhengrong, Yao Mi, Li Yang, Zou Chuan, Li Haixin, Cai Songtao, Guo Yi, Tong Yuling, Zhao Yang, Xu Zhijie

机构信息

Licun Community Health Service Center, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, 518033, China.

Department of Pharmacy, Peking University Third Hospital, Beijing, 100191, China.

出版信息

BMC Health Serv Res. 2025 Feb 3;25(1):197. doi: 10.1186/s12913-025-12351-2.

Abstract

BACKGROUND

Integrating hospital pharmacists into primary care settings can enhance the quality of patient care. However, the challenges vary across countries. China has piloted such collaborations between hospital pharmacists and primary care practitioners in recent years, but research on this subject is limited. This study aims to examine the integration of hospital pharmacists into primary care settings in Shenzhen, China, and identify the perceived barriers and facilitators.

METHODS

From May 1 to November 30, 2022, a qualitative study gathered key informant interviews and on-site observations at three community health centers (CHCs) in Shenzhen. Two researchers collected the data, and all interviews were audio-recorded, transcribed verbatim, and analyzed using a thematic approach.

RESULTS

Seventeen key informants were recruited (eight hospital pharmacists, six GPs, and three health administrators), most of whom were women (n = 11). Hospital pharmacists mainly conduct medication reviews and consultations in clinics or pharmacies of CHCs and engage in home visits with GPs in a few cases. Barriers to their integration include pharmacists' inadequate competency, a lack of patient recognition, GPs' resistance, and insufficient technological support. Patient needs, incentive systems, administrative leadership, social media use, and colocation were identified as facilitators of integration.

CONCLUSION

While unique opportunities may exist for primary care settings to improve patient care by integrating hospital pharmacists, it is essential to address the barriers stemming from individuals and the health system. Efforts should focus on the targeted training of pharmacists' practical skills, strategic campaigns to raise awareness among the public and healthcare providers, and policy-led efforts to foster technological progress.

摘要

背景

将医院药剂师纳入基层医疗环境可提高患者护理质量。然而,各国面临的挑战各不相同。近年来,中国已试点了医院药剂师与基层医疗从业者之间的此类合作,但关于这一主题的研究有限。本研究旨在探讨中国深圳医院药剂师融入基层医疗环境的情况,并确定感知到的障碍和促进因素。

方法

2022年5月1日至11月30日,一项定性研究在深圳的三个社区卫生中心(CHC)收集了关键信息访谈和现场观察资料。两名研究人员收集数据,所有访谈均进行录音、逐字转录,并采用主题分析法进行分析。

结果

共招募了17名关键信息提供者(8名医院药剂师、6名全科医生和3名卫生管理人员),其中大多数为女性(n = 11)。医院药剂师主要在社区卫生中心的诊所或药房进行用药审查和咨询,少数情况下会与全科医生进行家访。他们融入的障碍包括药剂师能力不足、患者认可度低、全科医生抵触以及技术支持不足。患者需求、激励系统、行政领导、社交媒体使用和同地办公被确定为融合的促进因素。

结论

虽然基层医疗环境通过整合医院药剂师改善患者护理可能存在独特机会,但必须解决来自个人和卫生系统的障碍。应努力集中于针对性地培训药剂师的实践技能、开展提高公众和医疗服务提供者认识的战略活动以及政策引导的促进技术进步的努力。

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