Burnand Alice, Kantilal Kumud, Woodward Abi, Bhanu Cini, Manthorpe Jill, Orlu Mine, Rait Greta, Samsi Kritika, Sampson Liz, Vickerstaff Victoria, Wilcock Jane, Jani Yogini, Davies Nathan
Research Department of Primary Care and Population Health, Centre for Ageing Population Studies, University College London, London, United Kingdom.
Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, QMUL, London, United Kingdom.
PLoS One. 2025 Jun 24;20(6):e0325472. doi: 10.1371/journal.pone.0325472. eCollection 2025.
People with dementia experience complex healthcare needs. Clinical pharmacists play a crucial role in optimising medication management and ensuring patient safety within the primary care setting. However, little is known about the specific barriers and challenges they face when delivering dementia care. This study investigates the safety of dementia care in the community, focusing on the experiences of clinical pharmacists.
A qualitative study using semi-structured interviews with clinical pharmacists. Data analysis employed codebook thematic analysis, guided by the SEIPS 2.0 framework.
Thirteen clinical pharmacists were interviewed. Key risks include variations in pharmacist expertise, communication barriers, limited resources, and systemic challenges. Using the SEIPS 2.0 framework, the complex interactions between work systems (people, tools, tasks, organisation and environment) and work processes were identified, which impact safety outcomes for both clinical pharmacists and people with dementia.
Interviews revealed a spectrum of risks associated with dementia care in primary care. This study highlights the complex interplay of factors influencing the safety of dementia care. A proactive, multifaceted approach addressing training, interprofessional collaboration, and system-level adaptations is crucial to mitigate these risks and enhance patient safety in dementia care.
患有痴呆症的人有复杂的医疗保健需求。临床药剂师在优化药物管理和确保初级保健环境中的患者安全方面发挥着关键作用。然而，对于他们在提供痴呆症护理时所面临的具体障碍和挑战知之甚少。本研究调查社区中痴呆症护理的安全性，重点关注临床药剂师的经验。
采用对临床药剂师进行半结构化访谈的定性研究。数据分析采用码本主题分析，以SEIPS 2.0框架为指导。
对13名临床药剂师进行了访谈。主要风险包括药剂师专业知识的差异、沟通障碍、资源有限和系统性挑战。使用SEIPS 2.0框架，确定了工作系统（人员、工具、任务、组织和环境）与工作流程之间的复杂相互作用，这对临床药剂师和痴呆症患者的安全结果都有影响。
访谈揭示了初级保健中与痴呆症护理相关的一系列风险。本研究强调了影响痴呆症护理安全的因素之间的复杂相互作用。采取积极主动、多方面的方法来解决培训、跨专业协作和系统层面的调整问题，对于降低这些风险和提高痴呆症护理中的患者安全至关重要。
