Is non-prescription oseltamivir availability under strict criteria workable? A qualitative study in New Zealand
Is non-prescription oseltamivir availability under strict criteria workable? A qualitative study in New Zealand
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DOI：
10.1093/jac/dkq409
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发表时间：
2011-01-01
影响因子：
5.2
通讯作者：
Shaw, John
中科院分区：
文献类型：
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作者：
Gauld, Natalie;Kelly, Fiona;Shaw, John
2007年，新西兰成为第一个非处方提供奥司他韦（达菲）的国家。制定了严格的供应规则，以确保潜在的公共卫生利益与可能的风险相平衡。我们希望通过阐明药剂师对非处方奥司他韦供应的态度和经验来探索实施这一独特决定的成功之处。对26名社区药剂师进行了半结构化访谈，并使用框架方法进行了分析。大多数参与者对非处方奥司他韦的可用性持积极态度，大多数人似乎成功地应用了规则。然而，有些规则很难回忆和/或令人沮丧。供应似乎不是由潜在的商业利益驱动的，不适当的要求是可以管理的。其中一些是由其他卫生专业人员推动的。药剂师重视供应商提供的“药剂师协议”和“咨询记录”，并随时准备使用。某些规定可能会限制消费者获得药物，药剂师通常对推荐药物持保守态度。虽然药剂师欢迎非处方奥司他韦，但供应规定使药剂师感到沮丧，并限制了潜在的公共健康益处。如果根据各种供应规则对药品进行重新分类，则需要沿着多次提醒药剂师和其他卫生专业人员遵守供应规则，并说明这些规则的理由。在供应时使用的协议和/或咨询垫可能会受到重视，并且在存在错误召回规则的风险时是一种重要的帮助。可用性第一年的研究可能会突出需要解决的问题。
In 2007, New Zealand became the first country to make oseltamivir (Tamiflu((R))) available off prescription. Strict rules for supply were developed to ensure that potential public health benefits were balanced against possible risks. We wished to explore the success of implementing this unique decision through elucidating pharmacists' attitudes to and experiences of non-prescription supply of oseltamivir.Semi-structured interviews with a maximum variation sample of 26 community pharmacists were conducted and analysed using a framework approach.Most participants were positive about non-prescription availability of oseltamivir with the majority appearing to apply the rules successfully. However, some rules were difficult to recall and/or frustrating. Supply did not appear to be driven by potential for commercial gain and the inappropriate requests were manageable. Some of these were driven by other health professionals. Pharmacists valued the manufacturer-supplied 'Pharmacist Protocol' and 'Consultation Record' and kept them ready for use. Certain rules potentially restricted consumer access and pharmacists were generally conservative about recommending the medicine.While pharmacists welcomed non-prescription oseltamivir, the rules for supply frustrated pharmacists and limited potential public health benefits. If medicines are reclassified with various rules of supply, multiple reminders of the rules for supply to pharmacists and other health professionals are desirable along with the rationale for such rules. Protocols and/or consultation pads for use at time of supply are likely to be valued and are an important aid where there is a risk of faulty recall of rules. Research in the first year of availability may highlight issues to address.