Community Pharmacy Service for Patients With Inhaled Medications: A Multi-Perspective Observation and Assessment Under Routine Conditions

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice Pub Date : 2025-09-08 DOI:10.1111/jep.70271

Ann-Christin Kroenert, Lucas Freyberg, Claudia Sehmisch, Sebastian Michael, Thilo Bertsche

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引用次数: 0

Abstract

Rationale

Outcome studies have shown the benefits of inhalation consultations. Therefore, the service of inhalation consultations from pharmacists has been implemented in guidelines. Recently, this service became reimbursable for German community pharmacies.

Aims

We aimed to investigate how this service is performed under routine conditions to actually achieve the proven benefits.

Methods

We evaluated the reimbursed inhalation service under routine conditions in community pharmacies in Saxony, Germany. An external trained monitor observed routine services and documented predefined handling errors in patients' inhalation demonstrations. Besides, the monitor checked which contents of predefined checklists were addressed. After the consultations, patients and pharmaceutical staff were asked about the pervious service via a questionnaire.

Results

We analysed 48 reimbursed inhalation services in 13 different community pharmacies. Most consultations were on metered dose inhalers and dry powder inhalers, with 42% (20/48) each. We observed a median of n = 2 handling errors per patient (Q25: 1; Q75: 3). On average, 77% of those two errors were addressed by the pharmaceutical staff during the following consultation (95% confidence interval [69%; 86%]; minimum: 0%; maximum: 100%). Overall, patients' contentment with the service was very high (overall median: 5), while pharmaceutical staff's contentment was high (overall median: 4). There was no correlation between duration and unaddressed errors (r = 0.16; p = 0.35) or patients' contentment (r = 0.19; p = 0.26).

Conclusion

Handling errors in patients' inhalation technique were common but mostly recognized and addressed by the pharmaceutical staff during the reimbursed inhalation service. Patients' contentment with the service was high to very high, and they were usually more content with the service than the pharmaceutical staff.

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社区药房对吸入药物患者的服务：常规条件下的多视角观察与评价

理由：结果研究显示吸入咨询的益处。因此，药剂师吸入咨询服务已在指南中实施。最近，这项服务开始为德国社区药房报销。我们的目的是研究如何在常规条件下执行该服务，以实际实现已证实的好处。方法对德国萨克森州社区药房常规条件下的有偿吸入服务进行评价。一名外部训练有素的监测员观察了常规服务，并记录了患者吸入演示中预先确定的处理错误。此外，监视器还检查了预定义清单中的哪些内容被寻址。会诊后，通过问卷向患者和药学人员询问之前的服务情况。结果我们分析了13家不同社区药房的48项报销吸入服务。大多数咨询是计量吸入器和干粉吸入器，各占42%（20/48）。我们观察到每位患者的处理错误中位数为n = 2 （Q25: 1; Q75: 3）。平均而言，这两个错误的77%是由药学人员在后续会诊中解决的（95%置信区间[69%；86%]；最小：0%；最大：100%）。总体而言，患者对服务的满意度非常高（总体中位数：5），而药学人员的满意度较高（总体中位数：4）。持续时间与未解决的错误（r = 0.16; p = 0.35）或患者满意度（r = 0.19; p = 0.26）之间没有相关性。结论在报销式吸入服务中，患者吸入技术处理错误较为常见，但多为药学人员所认识和处理。患者对服务的满意度从高到非常高，患者对服务的满意度通常高于药学人员。

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来源期刊

Journal of evaluation in clinical practice 医学-卫生保健

CiteScore

4.80

自引率

4.20%

发文量

143

审稿时长

3-8 weeks

期刊介绍： The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.