Pendergast J F, Kimberlin C L, Berardo D H, McKenzie L C
Department of Statistics, University of Florida, Gainesville 32610, USA.
Soc Sci Med. 1995 Feb;40(4):557-65. doi: 10.1016/0277-9536(94)e0106-3.
Community pharmacists are being assigned increased responsibility in assuring the appropriateness and effectiveness of drug therapy. This increased responsibility is reflected in recently passed legislation (OBRA '90) in the United States that requires pharmacists to counsel patients about prescriptions received and to engage in prospective drug use review for Medicaid recipients. The potential impact of this legislation is unclear due to a dearth of research evaluating the effects of community pharmacists' activities on medication use. In addition, there is little research on pharmacists' willingness to assume increased responsibility. Research that would demonstrate the effectiveness of community pharmacists in improving therapeutic outcomes is hampered by problems inherent in conducting experimentally designed research in field settings. This paper examines two issues of concern in such studies--namely, the extent to which those who agree to participate in a demonstration project differ from those who decline to participate and the extent to which differential dropout from treatment and control conditions compromise the comparability of the two groups. Specifically, this report examines pharmacist characteristics related to participation in a demonstration project to improve the care of elderly patients. Community pharmacists in Florida who had earlier been asked to participate in a demonstration project (N = 418) were sent mail questionnaires to assess their attitudinal, demographic and employment characteristics. In particular, researchers were interested in the role orientation of pharmacists in regard to patient counseling and physician consultation, satisfaction with current jobs and career choices, employment settings and treatment vs control group assignment as predictors of participation in the research project. Demographic characteristics were also examined as possible predictors of participation.(ABSTRACT TRUNCATED AT 250 WORDS)
社区药剂师在确保药物治疗的合理性和有效性方面被赋予了更多责任。这种责任的增加体现在美国最近通过的立法（《1990年综合预算协调法案》）中，该法案要求药剂师就患者所开的处方为其提供咨询，并对医疗补助接受者进行前瞻性药物使用审查。由于缺乏评估社区药剂师活动对药物使用影响的研究，这项立法的潜在影响尚不清楚。此外，关于药剂师承担更多责任意愿的研究也很少。在实地环境中进行实验性设计研究存在固有问题，这阻碍了能够证明社区药剂师在改善治疗效果方面有效性的研究。本文探讨了此类研究中两个令人关注的问题，即同意参与示范项目的人与拒绝参与的人在多大程度上存在差异，以及治疗组和对照组不同的退出率在多大程度上损害了两组的可比性。具体而言，本报告考察了与参与改善老年患者护理示范项目相关的药剂师特征。向佛罗里达州此前被邀请参与示范项目的社区药剂师（N = 418）发送了邮寄问卷，以评估他们的态度、人口统计学和就业特征。研究人员尤其感兴趣的是药剂师在患者咨询和医生会诊方面的角色定位、对当前工作和职业选择的满意度、就业环境以及作为参与研究项目预测因素的治疗组与对照组分配情况。人口统计学特征也作为参与的可能预测因素进行了考察。（摘要截选至250词）
