Zhongguo quanke yixue (Nov 2023)
Current Situation of Community Pharmacy Services and the Integration of Pharmacists into Family Doctor Team in Shanghai
Abstract
Background At present, polypharmacy is common among residents with high risk of unsafe medication due to the lack of drug reorganization and whole-course drug management. Community pharmacy services provided by community health service centers (CHSC) with regional advantages is in line with its functional orientation, but there is still a large gap between the supply of pharmacy services in CHSCs and the demand of the public. Objective To understand the current situation of community pharmacy services and the integration of pharmacists into family doctor team in Shanghai, as well as the problems faced by community pharmacy services, so as to provide suggestions for promoting the development of community pharmacy services. Methods A combination of qualitative and quantitative research was adopted. In December 2020, a stratified sampling method was used to conduct a questionnaire survey on 307 pharmacy staff on duty with licensed pharmacist qualification from 29 CHSCs, including 6 in the central urban area, 8 in the near urban area, and 15 in the far urban area. The questionnaire included the basic information of pharmaceutical staff, the development of community pharmacy services, and the participation of community pharmacists in the family doctor team. In the same period, a convenience sampling method was used to invite 29 key insiders, including 11 pharmacy section chiefs, 6 family doctor representatives, 12 community center directors and health commission managers from central urban area, near urban area and far urban area, to conduct a semi-structured focus interview on pharmacy service needs, pharmacy resource allocation and pharmacy service process. Results The quantitative research results showed that the highest proportion of community pharmacists participating in training is 1-2 times〔139 (45.3%) 〕, and the main form of training is continuing education, accounting for 252 (82.1%). The three most frequently conducted pharmacy service projects by community pharmacists are prescription dispensing〔284 (92.5%) 〕, prescription review〔253 (82.4%) 〕, and pharmaceutical window or outpatient consultation guidance〔196 (63.8%) 〕. The three longest service hours occupied by pharmacists are prescription dispensing〔280 (91.2%) 〕, prescription review〔244 (79.5%) 〕, and prescription comment〔145 (47.2%) 〕. A total of 78 (25.4%) pharmacists joined the family doctor team. The qualitative study showed that the elderly residents in the community had a great demand for pharmacy service, but their awareness of rational drug use was weak. In the allocation of community pharmacy resources, the pharmacists are lacjing, the professional quality needs to be improved, the community pharmacy drug list remains uncompleted, and the role of informatization needs to be strengthened. In the process of community pharmacy service, the recognition degree of community pharmacists is not high, with single service content and relatively little targeted training on rational drug use, and pharmacists fail to play a role in the family doctor team. Conclusion At present, the resource allocation and supply capacity of community pharmacy service cannot meet the needs of residents, and the pharmacy service process needs to be improved and optimized. The role played by the only part of pharmacists joining the family doctor team is limited. Therefore, it is necessary to increase the incentive mechanism, clarify the service content and improve the service model.
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