患者参与者、医疗保健专业人员以及利益相关者对药房无家可归者外展参与非医疗独立处方Rx（PHOENIx）社区药房试点随机对照试验的看法。
Patient participant, healthcare professional, and stakeholder perspectives on the Pharmacy Homeless Outreach Engagement Non-medical Independent prescribing Rx (PHOENIx) community pharmacy pilot randomised controlled trial.
作者信息
Scobie Hannah, MacKinnon Shona, Wood Karen, Albanese Alessio, Cunningham Yvonne, Williamson Andrea, Moir Jane, McPherson Andrew, Lombard Cian, Ross Steven, Araf Adnan, Heath Helena, Lowrie Richard, Paudyal Vibhu, Mair Frances
机构信息
General Practice & Primary Care, School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland.
NHS Greater Glasgow & Clyde, Scotland.
出版信息
PLoS One. 2025 Jun 27;20(6):e0324654. doi: 10.1371/journal.pone.0324654. eCollection 2025.
BACKGROUND
People experiencing homelessness (PEH) face complex health and social care needs, contributing to poor health outcomes and premature mortality. The Pharmacy Homeless Outreach Engagement Non-medical Independent prescribing Rx (PHOENIx) intervention was developed to address these challenges through assertive outreach by NHS pharmacist independent prescribers working with third sector homelessness charity workers for PEH presenting to community pharmacy. This qualitative study aims to explore participant, healthcare professional, and stakeholder perceptions of the PHOENIx intervention and acceptability of trial procedures.
METHODS
Semi-structured interviews were conducted with trial participants, internal stakeholders (healthcare professionals/researchers), and external stakeholders (national and local) across two intervention sites (Glasgow and Birmingham) between March 2023 and February 2024. Data was analysed thematically using Normalisation Process Theory (NPT) as a conceptual framework.
RESULTS
Participants (n = 26; usual care n = 7; intervention n = 19) viewed PHOENIx as distinctively comprehensive, consistent, and caring, valuing its holistic approach and the trusting relationships developed with the team. Stakeholders (n = 16; internal n = 5; external n = 11) recognised PHOENIx's potential to fill gaps in current service provision for PEH, appreciating its flexible, outreach-based model. Challenges identified included resource constraints, integration with existing services, and concerns about long-term sustainability.
CONCLUSIONS
The PHOENIx intervention shows promise in providing accessible, comprehensive healthcare which was acceptable to PEH. Its success in engaging this underserved population offers valuable lessons for service development. However, addressing challenges around resources, scalability, and sustainability will be important considerations for a future trial and wider implementation and expansion.
背景
无家可归者面临复杂的健康和社会护理需求，导致健康状况不佳和过早死亡。“药房无家可归者外展参与非医疗独立处方计划（PHOENIx）”干预措施旨在应对这些挑战，由国民保健制度药剂师独立处方者与第三部门无家可归者慈善工作者积极开展外展工作，为前往社区药房的无家可归者提供服务。这项定性研究旨在探讨参与者、医疗保健专业人员和利益相关者对PHOENIx干预措施的看法以及试验程序的可接受性。
方法
2023年3月至2024年2月期间，在两个干预地点（格拉斯哥和伯明翰）对试验参与者、内部利益相关者（医疗保健专业人员/研究人员）和外部利益相关者（国家和地方）进行了半结构化访谈。使用归一化过程理论（NPT）作为概念框架对数据进行主题分析。
结果
参与者（n = 26；常规护理组n = 7；干预组n = 19）认为PHOENIx具有独特的全面性、连贯性和关怀性，重视其整体方法以及与团队建立的信任关系。利益相关者（n = 16；内部n = 5；外部n = 11）认识到PHOENIx有潜力填补当前为无家可归者提供服务的空白，赞赏其灵活的、基于外展的模式。确定的挑战包括资源限制、与现有服务的整合以及对长期可持续性的担忧。
结论
PHOENIx干预措施在提供无家可归者可接受的可及、全面医疗保健方面显示出前景。其在吸引这一服务不足人群方面的成功为服务发展提供了宝贵经验。然而，应对资源、可扩展性和可持续性方面的挑战将是未来试验以及更广泛实施和扩展的重要考虑因素。
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