Background

Many community pharmacies provide medication and disease state management services with and without specific remuneration. Availability of these services is often reported, however little is known about factors influencing the intensity of their provision.

Objective

To investigate factors associated with the intensity of provision of selected government remunerated and unremunerated community pharmacy services in Western Australia (WA).

Methods

A questionnaire was mailed to a random sample of 421/628 (67%) community pharmacies in WA. The first dependent variable was intensity of government remunerated MedsCheck and Diabetes MedsCheck service frequencies per month. The second was the intensity of the sum of government unremunerated asthma screening, blood glucose testing, cholesterol testing and smoking cessation disease state management service frequencies per week. Principal Component Analysis defined attitudinal components influencing service provision. Linear regression with bootstrap confidence intervals determined variables associated with intensity of provision of the selected services. The variables were: pharmacist; pharmacy setting characteristics; and, attitudinal factors.

Results

The questionnaire yielded a response rate of 49.2%. Attitudinal components that facilitated service provision were: general practitioners (GPs) willingness to collaborate; pharmacists are capable and ready; and pharmacists require further training. Staff capability and low return on investment were barriers to increased service provision. The intensity of government remunerated services was independently associated with pharmacies having pharmacy interns, fewer dispensary technicians, and being capable and ready to provide the services. Higher intensity of the provision of the unremunerated disease state management services was independently associated with the intensity of provision of MedsCheck and Diabetes MedsCheck services.

Conclusions

Improved pharmacy workflow, achieved by the availability of pharmacy interns, and pharmacists being capable and ready, were important factors in the intensity of MedsCheck and Diabetes MedsCheck services. Intensity of the provision of government remunerated services facilitated a higher prevalence of disease state management services provision.

中文翻译：

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与社区药房政府有偿和无偿服务提供强度相关的因素

背景

许多社区药房提供药物和疾病状态管理服务，有无特定报酬。经常报告这些服务的可用性，但对影响其提供强度的因素知之甚少。

客观的

调查与西澳大利亚 (WA) 特定政府有偿和无偿社区药房服务提供强度相关的因素。

方法

一份问卷被邮寄到西澳州 421/628 (67%) 家社区药房的随机样本中。第一个因变量是政府每月支付的 MedsCheck 和糖尿病 MedsCheck 服务频率的强度。第二个是每周政府无偿哮喘筛查、血糖检测、胆固醇检测和戒烟疾病状态管理服务频率之和的强度。主成分分析定义了影响服务提供的态度成分。带有自举置信区间的线性回归确定了与所选服务的提供强度相关的变量。变量是：药剂师；药房设置特点；以及，态度因素。

结果

问卷的回复率为 49.2%。促进服务提供的态度要素是：全科医生 (GP) 愿意合作；药剂师有能力并且准备好了；药剂师需要进一步培训。员工能力和投资回报率低是增加服务提供的障碍。政府有偿服务的强度与药店有药房实习生、较少的药房技术人员、有能力和愿意提供服务独立相关。提供无偿疾病状态管理服务的较高强度与提供 MedsCheck 和糖尿病 MedsCheck 服务的强度独立相关。

结论

药房实习生的可用性和药剂师的能力和准备的改进药房工作流程是 MedsCheck 和糖尿病 MedsCheck 服务强度的重要因素。提供政府有偿服务的强度促进了疾病状态管理服务提供的更高流行率。