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市级环境下非传染性疾病管理的多部门跨专业协作评估:一项混合方法研究

Evaluation of multisectoral interprofessional collaboration for non-communicable disease management within a municipal setting: a mixed methods study.

作者信息

Denkyira Salomey Asaah, Oppong Kwaku Gyamfi, Boateng Daniel, Attakorah Joseph, Buabeng Kwame Ohene

机构信息

Faculty of Pharmacy and Pharmaceutical Sciences, Department of Pharmacy Practice, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

University of Ghana Medical Centre, Pharmacy Directorate, Accra, Ghana.

出版信息

BMC Prim Care. 2025 Aug 5;26(1):245. doi: 10.1186/s12875-025-02937-4.

Abstract

BACKGROUND

Strengthening multisectoral collaboration is essential for NCD prevention and control. In Ghana, the healthcare system often experiences inefficiencies due to fragmented care pathways and limited patient engagement. In this study, we assessed the collaboration and level of satisfaction on collaboration between healthcare professionals (HCPs) in hospital settings and Community pharmacists (CPs) in community pharmacies in the management of Diabetic/hypertensive (DM/HPT) patients in Ghana.

METHOD

This was a cross-sectional study conducted in the Oforikrom municipality in Kumasi Metropolis. A mixed methods approach was used. Participants included all CPs and HCPs practicing in the municipality, as well as DM/HPT patients receiving care at the study site. Quantitative data was collected through online questionnaires. To gather qualitative insights, semi-structured interviews were further conducted. The interviews were audio-recorded and transcribed, and key themes were extracted.

RESULTS

A total of 170 participants (HCPs (n = 30), CPs (n = 39), and DM/HPT patients (n = 101)) completed the survey. Subsequently, seven (7) CPs and five (5) HCPs also participated in interviews. The study showed that CPs, HCPs and DM/HPT patients collaborated through practices such as sending referrals & making recommendations for therapy, follow-ups on patients' therapy and outcomes assessment, providing feedback, adherence support and reminders. The quantitative data suggested a potential communication gap in the referral process between CPs and HCPs. The qualitative data showed that, despite both CPs and HCPs acknowledging the benefits of collaborative practice, it is currently limited. Furthermore, the study revealed varied levels of satisfaction on collaboration for NCD management. An equal proportion (40%) of both CPs and HCPs expressed satisfaction with their collaborative practices with each other, and 25% from each group reported dissatisfaction. The remaining participants were neither satisfied nor dissatisfied. The majority (78%) of CPs and an appreciable proportion of patients (34%) were satisfied with their collaborative relationship for patient care. However, a significant proportion (60%) of patients were dissatisfied with the overall collaboration between HCPs and CPs.

CONCLUSION

The study highlights gaps in collaborative practice between healthcare providers (CPs, HCPs) and NCD patients, notably revealing patient dissatisfaction with the overall inter-professional collaboration, indicating a need for improved communication, bi-directional referral systems, and teamwork to optimize care and improve health outcomes.

摘要

背景

加强多部门合作对于非传染性疾病的预防和控制至关重要。在加纳,由于护理路径分散和患者参与度有限,医疗系统常常效率低下。在本研究中,我们评估了加纳医院环境中的医疗专业人员(HCPs)与社区药房中的社区药剂师(CPs)在糖尿病/高血压(DM/HPT)患者管理方面的合作情况以及对合作的满意度。

方法

这是一项在库马西大都会奥福里克罗姆市进行的横断面研究。采用了混合方法。参与者包括该市所有执业的CPs、HCPs以及在研究地点接受护理的DM/HPT患者。通过在线问卷收集定量数据。为了获取定性见解,进一步进行了半结构化访谈。访谈进行了录音和转录,并提取了关键主题。

结果

共有170名参与者(HCPs(n = 30)、CPs(n = 39)和DM/HPT患者(n = 101))完成了调查。随后,七名(7)CPs和五名(5)HCPs也参与了访谈。研究表明,CPs、HCPs和DM/HPT患者通过诸如发送转诊和提出治疗建议、对患者治疗和结果评估进行随访、提供反馈、依从性支持和提醒等做法进行合作。定量数据表明CPs和HCPs之间在转诊过程中可能存在沟通差距。定性数据显示,尽管CPs和HCPs都承认合作实践的益处,但目前这种合作有限。此外,该研究揭示了对非传染性疾病管理合作的不同程度的满意度。CPs和HCPs中各有40%的比例对彼此的合作实践表示满意,每组中有四分之一的比例表示不满意。其余参与者既不满意也不不满意。大多数(78%)CPs和相当比例的患者(34%)对他们在患者护理方面的合作关系感到满意。然而,相当比例(60%)的患者对HCPs和CPs之间的整体合作不满意。

结论

该研究突出了医疗服务提供者(CPs、HCPs)与非传染性疾病患者之间合作实践的差距,尤其表明患者对整体跨专业合作不满意,这表明需要改善沟通、双向转诊系统和团队合作,以优化护理并改善健康结果。

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