Background

Findings document that patient participation in pharmacy encounters is associated with favorable outcomes. However, there is a need to understand factors that may enhance or hinder patient engagement and pharmacist counseling behaviors during their medication discussions. This review aims to: (1) identify barriers and facilitators for patient engagement in pharmacy consultations, (2) explore the relationship between patient factors (such as demographics and communication behavior) and subsequent pharmacist counseling behavior.

Methods

A systematic review of literature using PRISMA guidelines examined studies published in English addressing influences on patient participation and the relationship between patient factors and pharmacist counseling behavior. Four databases were used - PubMed, CINAHL, PsycINFO, and Scopus. Findings were framed thematically within the constructs of Street's Linguistic Model of Patient Participation in Care (LM).

Findings

Fifty studies from 1983 to 2019, including 37 using self-reported data, were identified. Patient involvement in patient-pharmacist communication was influenced by enabling factors such as patient knowledge, communication skills, and pharmacy environment. Predisposing factors for participation ranged from patients' beliefs and past experiences to demographic characteristics such as gender and age. Pharmacists' participative behavior with patients was positively associated with patients’ engagement and perceived patient cues in the conversation.

Conclusion

This systematic review identified predictors of patients' engagement in pharmacy encounters drawing on LM framework. Various predisposing factors, enabling factors, and pharmacist’ responses impacted patients' willingness to actively participate in medication counseling at community pharmacies. Equally important, studies documented considerable impact by patients on pharmacists' counseling behavior. Pharmacy encounters should no longer be viewed as controlled simply by pharmacists’ expertise and agendas. Patient characteristics and factors such as patient question-asking and expectations also appear to be associated with and influence patient-pharmacist interpersonal communication. Additional research needs to address the identified facilitators and barriers to enhance patient participation and pharmacist counseling behavior.

中文翻译：

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影响患者参与社区药房药物咨询的因素：系统评价

背景

调查结果表明，患者参与药房会面与良好的结果相关。然而，需要了解在药物讨论期间可能增强或阻碍患者参与和药剂师咨询行为的因素。本综述旨在：（1）确定患者参与药房咨询的障碍和促进因素，（2）探讨患者因素（如人口统计学和沟通行为）与随后的药剂师咨询行为之间的关系。

方法

使用 PRISMA 指南对文献进行的系统回顾检查了以英文发表的研究，这些研究涉及对患者参与的影响以及患者因素与药剂师咨询行为之间的关系。使用了四个数据库 - PubMed、CINAHL、PsycINFO 和 Scopus。调查结果在 Street 的患者参与护理语言模型 (LM) 的结构中按主题进行了框定。

发现

确定了 1983 年至 2019 年的 50 项研究，其中包括 37 项使用自我报告的数据。患者参与患者与药剂师沟通受到患者知识、沟通技巧和药房环境等促成因素的影响。参与的诱发因素包括患者的信仰和过去的经历，以及性别和年龄等人口统计学特征。药剂师与患者的参与行为与患者的参与度和在对话中感知到的患者线索呈正相关。

结论

该系统评价利用 LM 框架确定了患者参与药房遭遇的预测因素。各种诱发因素、促成因素和药剂师的反应影响了患者积极参与社区药房药物咨询的意愿。同样重要的是，研究记录了患者对药剂师咨询行为的巨大影响。药房会面不应再被视为仅由药剂师的专业知识和议程控制。患者特征和诸如患者提问和期望等因素似乎也与患者-药剂师的人际交流相关并会影响患者-药剂师的交流。其他研究需要解决已确定的促进因素和障碍，以增强患者参与和药剂师咨询行为。