探讨社区药剂师在抗血栓药物围手术期管理中的作用:障碍、促进因素和未来方向的定性研究。

IF 3.2 4区 医学 Q2 PHARMACOLOGY & PHARMACY
Andreas Capiau, Isaura Kint, Els Mehuys, Tine De Backer, Annemie Somers, Koen Boussery
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引用次数: 0

摘要

导论:抗血栓药物被认为是高风险药物,特别是在围手术期,因为出血的风险增加。在侵入性手术中,平衡出血和血栓风险是至关重要的。社区药剂师(CPs)在围手术期抗血栓管理中的具体作用尚不清楚。目的:本研究旨在探讨CPs在围手术期抗血栓管理中的作用,重点关注他们的经验,以及扩大他们参与的障碍和促进因素。方法:一项定性研究于2024年3月至5月在比利时进行,采用半结构化的深度访谈与CPs。理论领域框架指导访谈指南的制定,以确保相关领域的全面覆盖。访谈由两位独立研究人员逐字转录,并在NVivo 14中使用开放和轴向编码进行主题分析。参与者被随机抽取和招募,直到没有新的主题产生。结果:共13名CPs参与深度访谈,其中女性7名,中位年龄48岁,IQR 34-58岁。出现了四个关键主题:(i)目前CPs在围手术期抗血栓管理中的参与,(ii)影响CPs角色的因素,(iii)角色扩展的愿望和感知机会,以及(iv)优化CPs贡献的拟议策略。CPs描述他们目前的作用是有限的,主要是反应性的,通常发生在术后。报告的障碍包括抗血栓治疗方案知识不足、时间限制、医院指南不一致且不透明、无法获得相关医疗记录以及难以联系到医院处方医生。促进因素包括CPs监督患者完整药物治疗方案的独特地位,强大且值得信赖的患者关系,出院后早期联系以及更积极贡献的内在动机。与会者表示希望在有组织的培训的支持下,更积极主动地合作参与。他们还强调,必须制定清晰易懂的指导方针,并在各医院之间尽可能统一。最后,他们强调需要更好地获得处方者,以促进更有效的沟通。结论:CPs在围手术期抗血栓管理中的作用目前有限,尤其是术前。解决已确定的障碍和实施建议的改进措施可以加强它们的作用。需要进一步的研究来验证这些发现并指导未来的干预措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Exploring the role of community pharmacists in perioperative management of antithrombotic agents: a qualitative study of barriers, facilitators, and future directions.

Introduction: Antithrombotic agents are considered as high-risk medications, particularly during the perioperative period, because of the increased risk of bleeding. Balancing bleeding and thrombosis risks is crucial in the context of invasive procedures. The specific role of community pharmacists (CPs) in perioperative antithrombotic management remains unclear.

Aim: This study aimed to explore the role of CPs in perioperative antithrombotic management, focusing on their experiences, and the barriers and facilitators to expand their involvement.

Method: A qualitative study was conducted in Belgium between March and May 2024 using semi-structured, in-depth interviews with CPs. The Theoretical Domains Framework guided the development of the interview guide to ensure comprehensive coverage of relevant domains. Interviews were transcribed verbatim and analysed thematically using open and axial coding in NVivo 14 by two independent researchers. Participants were randomly sampled and recruited until no new themes were generated.

Results: A total of 13 CPs (7 female; median age 48 years, IQR 34-58) participated in the in-depth interviews. Four key themes emerged: (i) current involvement of CPs in perioperative antithrombotic management, (ii) factors influencing CPs' role, (iii) aspirations and perceived opportunities for role expansion, and (iv) proposed strategies to optimise CPs' contributions. CPs described their current role as limited and mainly reactive, with their involvement typically occurring postoperatively. Reported barriers included insufficient knowledge of antithrombotic protocols, time constraints, inconsistent and non-transparent hospital guidelines, lack of access to relevant medical records, and difficulty reaching hospital-based prescribers. Facilitators included CPs' unique position to oversee a patient's full medication regimen, strong and trusted patient relationships, early post-discharge contact, and intrinsic motivation to contribute more actively. Participants expressed a desire for more proactive and collaborative involvement, supported by structured training. They also stressed the importance of clear, well-accessible guidelines that are as uniform as possible across hospitals. Lastly, they emphasised the need for better accessibility to prescribers to facilitate more effective communication.

Conclusion: CPs' role in perioperative antithrombotic management is currently limited, particularly preoperatively. Addressing identified barriers and implementing the suggested improvements could strengthen their role. Further research is needed to validate these findings and guide future interventions.

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来源期刊
CiteScore
4.10
自引率
8.30%
发文量
131
审稿时长
4-8 weeks
期刊介绍: The International Journal of Clinical Pharmacy (IJCP) offers a platform for articles on research in Clinical Pharmacy, Pharmaceutical Care and related practice-oriented subjects in the pharmaceutical sciences. IJCP is a bi-monthly, international, peer-reviewed journal that publishes original research data, new ideas and discussions on pharmacotherapy and outcome research, clinical pharmacy, pharmacoepidemiology, pharmacoeconomics, the clinical use of medicines, medical devices and laboratory tests, information on medicines and medical devices information, pharmacy services research, medication management, other clinical aspects of pharmacy. IJCP publishes original Research articles, Review articles , Short research reports, Commentaries, book reviews, and Letters to the Editor. International Journal of Clinical Pharmacy is affiliated with the European Society of Clinical Pharmacy (ESCP). ESCP promotes practice and research in Clinical Pharmacy, especially in Europe. The general aim of the society is to advance education, practice and research in Clinical Pharmacy . Until 2010 the journal was called Pharmacy World & Science.
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