弗吉尼亚州为社区药剂师服务实施全州协议:使用实施研究综合框架进行定性研究
Journal of the American Pharmacists Association : JAPhA
|October 31, 2025
概括
弗吉尼亚州的药剂师可以提供临床服务,但低利用率 (24%) 突出了实施障碍. 解决资源限制和工作流集成是扩大药房医疗保健的关键.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 实施科学 实施科学
- 药房实践 在药房实践.
背景情况:
- 2020年弗吉尼亚州立法允许药剂师通过全州协议提供临床服务.
- 使用率低 (24%) 需要了解实施挑战.
- 通过药房服务扩大医疗保健准入是公共卫生的优先事项.
研究的目的:
- 确定影响药剂师提供的临床服务全州协议实施的上下文因素.
- 检查弗吉尼亚州社区药房的障碍和促进者.
- 为提高药房临床服务的采用率制定战略.
主要方法:
- 与16名社区药剂师进行半结构面试 (2024年11月 - 2025年5月).
- 利用实施研究综合框架 (CFIR) 2.0进行面试指南的开发和分析.
- 采用了用于数据分析的CFIR构造的感应编码和演映射.
主要成果:
- 促进者包括患者感知到的访问利益和与专业角色的协调.
- 障碍包括资源限制,协议复杂性和结构问题 (空间,工作流).
- 独立药剂师报告了更多的自主权;农村药剂师在解决获取差距方面表现出创新.
结论:
- 全州范围的协议为改善医疗保健准入提供了潜力,但需要对资源限制和工作流集成进行干预.
- 有针对性的支持对于社区药房的成功实施至关重要.
- 独立和连锁药房需要定制策略来促进协议的采用.
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