Using the Human Factors Framework to understand the origins of medication safety problems in community pharmacy: A qualitative study
Using the Human Factors Framework to understand the origins of medication safety problems in community pharmacy: A qualitative study
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DOI：
10.1016/j.sapharm.2018.07.010
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发表时间：
2019-05-01
影响因子：
3.9
通讯作者：
Watson, Margaret
中科院分区：
文献类型：
--
作者：
Al Juffali, Lobna;Al-Aqeel, Sinaa;Watson, Margaret
背景：社区药房实践在沙特阿拉伯王国（KSA）面临许多挑战。在沙特阿拉伯，缺乏关于这种情况下用药安全性的实证研究。目的：探讨KSA社区药房药品供应的安全问题，并比较不同利益相关者的观点。方法：2013年2 - 5月在沙特阿拉伯利雅得进行4个焦点小组和个人访谈。除专业小组以英语进行讨论外，所有小组讨论都进行了记录、转录并从阿拉伯语翻译成英语。使用人因框架（HFF）进行主题分析。结果：分组包括“专业人员”（n = 8，女性1人）、社区药师（n = 4，男性1人）和2个药房用户组（女性11人，男性8人）。确定的药物安全问题被分为代表HFF的9类。从这些类别中确定了七个主题：社区药房的商业压力；非法供应处方药；规章执行不力；医疗保健系统；自我药疗;患者对药师的信任：与沟通失败。只有“专业人士”和社区药剂师提出的主题是监管机构的不同角色和执法不力背后的原因，而社区药剂师群体则关注业主与管理者之间的关系。药房使用者表达了对药物信息的需求，而药剂师的主要角色应该是作为信息提供者。此外，他们认为药剂师是供应商，而不是医疗保健专业人员。结论：发现了许多用药安全问题，可归因于个体（患者、药师）、药房和组织因素。这些结果将用于制定改善用药安全的干预措施。
Background: Community pharmacy practice in the Kingdom of Saudi Arabia (KSA) faces many challenges. In KSA, there is a lack of empirical research about medication safety in this setting.Objective: To explore the safety problems associated with medication supply from community pharmacies in KSA and compare different stakeholder perspectives.Methods: Four focus groups and individual interviews were conducted in Riyadh, KSA, in February-May 2013. All group discussions were recorded, transcribed and translated from Arabic into English, except the professional group, which was conducted in English. Thematic analysis was performed using the Human Factors Framework (HFF).Results: The groups comprised "professionals" (n = 8; one female), community pharmacists (n = 4; all male) and two pharmacy user groups (females, n = 11 and males, n = 8). Medication safety problems identified were categorised into nine categories representing the HFF. Seven main themes were identified from these categories: commercial pressure on community pharmacy; illegal supply of prescription medication; lack of enforcement of regulations; the healthcare system; self-medication; patient trust in pharmacists: and communication failure. Themes that emerged only from the "professionals" and community pharmacists were the different role of the regulatory organisations and the reasons behind lack of enforcement, while the community pharmacist group focused on the relationship between owners and managers. Pharmacy users expressed a need for information about medication and that the primary role of the pharmacist should be as an information provider. Furthermore, they perceived pharmacists to be vendors rather than healthcare professionals.Conclusion: Many medication safety problems were identified, attributable to individuals (patient, pharmacist), pharmacy and organisational factors. These results will be used to develop interventions to improve medication safety.