Andreas Capiau, Isaura Kint, Els Mehuys, Tine De Backer, Annemie Somers, Koen Boussery
{"title":"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。","authors":"Andreas Capiau, Isaura Kint, Els Mehuys, Tine De Backer, Annemie Somers, Koen Boussery","doi":"10.1007/s11096-025-01985-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Aim: </strong>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.</p><p><strong>Method: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Exploring the role of community pharmacists in perioperative management of antithrombotic agents: a qualitative study of barriers, facilitators, and future directions.\",\"authors\":\"Andreas Capiau, Isaura Kint, Els Mehuys, Tine De Backer, Annemie Somers, Koen Boussery\",\"doi\":\"10.1007/s11096-025-01985-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>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.</p><p><strong>Aim: </strong>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.</p><p><strong>Method: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>CPs' role in perioperative antithrombotic management is currently limited, particularly preoperatively. Addressing identified barriers and implementing the suggested improvements could strengthen their role. 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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.
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.