Understanding public trust in services provided by community pharmacists relative to those provided by general practitioners: a qualitative study
Understanding public trust in services provided by community pharmacists relative to those provided by general practitioners: a qualitative study
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DOI：
10.1136/bmjopen-2012-000939
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发表时间：
2012-01-01
期刊：
影响因子：
2.9
通讯作者：
McGregor, Lesley
中科院分区：
文献类型：
--
作者：
Gidman, Wendy;Ward, Paul;McGregor, Lesley
目的：应用社会学理论，了解公众的信任，由社区药剂师提供的扩展服务相对于那些由全科医生（GPs）提供的。设计：定性研究涉及焦点小组与members of the public.Setting：The West of Scotland.Participants：26有目的地抽样的公众成员参与了五个焦点小组之一。这些团体组成，以代表已知群体的用户和非用户的社区药房，即母亲与年幼的孩子，老年人和男子。结果：信任被认为是至关重要的医疗环境。焦点小组讨论显示，参与者倾向于在药剂师和全科医生之间进行不利的比较。重要的是，参与者对全科医生的信任大于药剂师。参与者认为药剂师主要参与药品供应，并且对药剂师的扩展作用的认识很低。参与者往往不愿意相信药剂师提供不熟悉的服务，特别是那些被认为是“高风险”。许多基于系统的因素被确定，这加强了患者对全科医生的信任和信心，包括全科医生注册和预约系统，全科医生的专家/看门人的角色和实践环境。我们的数据表明，公众与全科医生互动的性质和背景促进了对特定全科医生或实践的熟悉，这使得人际信任得以发展。相比之下，参与者接触社区药剂师的机会有限。此外，一个很好的理解全科医生的培训和作用的水平促进了confidence.Conclusion：目前英国的举措，其目的是实施一系列的药剂师主导的服务，被破坏缺乏公众的信任。公众似乎不太可能信任药剂师提供不熟悉的服务，这些服务被认为是“高风险”的，除非卫生系统以促进对药剂师信任的方式改变。这可以通过提高患者与药剂师互动的质量和数量以及获得GP对扩展药房服务的支持来实现。
Objectives: To apply sociological theories to understand public trust in extended services provided by community pharmacists relative to those provided by general practitioners (GPs).Design: Qualitative study involving focus groups with members of the public.Setting: The West of Scotland.Participants: 26 purposively sampled members of the public were involved in one of five focus groups. The groups were composed to represent known groups of users and non-users of community pharmacy, namely mothers with young children, seniors and men.Results: Trust was seen as being crucial in healthcare settings. Focus group discussions revealed that participants were inclined to draw unfavourable comparisons between pharmacists and GPs. Importantly, participants' trust in GPs was greater than that in pharmacists. Participants considered pharmacists to be primarily involved in medicine supply, and awareness of the pharmacist's extended role was low. Participants were often reluctant to trust pharmacists to deliver unfamiliar services, particularly those perceived to be 'high risk'. Numerous system-based factors were identified, which reinforce patient trust and confidence in GPs, including GP registration and appointment systems, GPs' expert/gatekeeper role and practice environments. Our data indicate that the nature and context of public interactions with GPs fostered familiarity with a specific GP or practice, which allowed interpersonal trust to develop. By contrast, participants' exposure to community pharmacists was limited. Additionally, a good understanding of the GPs' level of training and role promoted confidence.Conclusion: Current UK initiatives, which aim to implement a range of pharmacist-led services, are undermined by lack of public trust. It seems improbable that the public will trust pharmacists to deliver unfamiliar services, which are perceived to be 'high risk', unless health systems change in a way that promotes trust in pharmacists. This may be achieved by increasing the quality and quantity of patient interactions with pharmacists and gaining GP support for extended pharmacy services.