Zhongguo quanke yixue (Oct 2022)
Needs of Pharmaceutical Care in the Community of Shanghai
Abstract
Background To satisfy the pharmaceutical care needs of a growing number of patients seeking healthcare in primary care, it is increasingly important to integrate family doctor teams as providers of such care services, while the way bringing the strength of the teams into full play needs to be further explored. Objective To understand the needs of pharmaceutical care services in the community of Shanghai, providing a reference for improving the way of integrating community pharmacists into a family doctor team for delivering such services. Methods This study was conducted from September to December in 2020. Multistage sampling was used to select 349 elderly patients with chronic diseases in the community and 855 main members of family doctor teams〔general practitioners (n=481) , nurses (n=234) , and public health doctors (n=140) 〕 for questionnaire survey. The questionnaire for the patients mainly includes demographics, chronic condition, use of medications, needs and utilization of community-based pharmaceutical care. And the questionnaire for family doctor team members mainly contains demographics, understanding of community-based pharmaceutical care, and pharmaceutical services preferred to be involved in as a provider. Results According to the survey results, the prevalence of three or more chronic diseases, and needing to take medications two or more times a day was 35.8% (125/349) , and 87.4% (305/349) , respectively. Among medication management services, "medication re-prescribing and follow-up" was the most needed〔14.9% (52/349) 〕, and "medication follow-up" was the most used〔14.0% (49/349) 〕. Among medication education services, "universal education on medication cautions for chronic conditions" was the most needed〔70.8% (247/349) 〕, and "healthy lifestyle promotion" was the most used〔9.4% (33/349) 〕. Among family doctor team members, 440 (91.5%) general practitioners, 202 (86.3%) nurses and 112 (80.0%) public health doctors expressed that they had an understanding of pharmaceutical care. In terms of the level of trust in pharmacists, the self-reported level of 302 (62.8%) general practitioners, 183 (78.2%) nurses, and 103 (73.6%) public health doctors was high. The number of general practitioners, nurses, and public health doctors wanting to be involved in "assisting physicians in providing medication selection and use services" was 359 (74.6%) , 112 (47.9%) , and 81 (57.8%) , respectively. The number of general practitioners, nurses, and public health doctors wanting to be involved in "providing nurses with guidance on medication use and management" was 190 (39.5%) , 153 (65.4%) and 57 (40.7%) , respectively. Conclusion Elderly patients with chronic diseases were in urgent need of medication management services, and more medication education services. However, the strength of pharmaceutical professional workforce in the community was weak, and family doctor team members had limited understanding of community-based pharmaceutical services. To efficiently provide residents with such services, it is suggested to train family doctor team members with relevant trainings by pharmaceutical professionals to improve their understanding level and service capability regarding pharmaceutical services at the individual and team levels.
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