In the UK, there is ongoing integration of pharmacists into general practice as a new healthcare service in primary care. Evaluation of the service involves national measures that require pharmacists to record their work, on the general practice clinical computer systems, using electronic activity codes. No national agreement, however, has been established on what activities to record. The purpose of this study was to attempt to reach consensus on what activities general practice-based pharmacists should record. The e-Delphi method was chosen as it is an excellent technique for achieving consensus. The study began with an initial stage in which screening of a general practice clinical computer system and discussion groups with pharmacists from two ‘pharmacists in general practice’ sites identified 81 codes potentially relevant to general practice-based pharmacists’ work. Twenty-nine experts (pharmacists and pharmacy technicians from the two sites along with experts recruited through national committees) were then invited by e-mail to participate as a panel in three e-Delphi questionnaire rounds. In each round, panellists were asked to grade or rank codes and justify their choices. In every round, panellists were provided with anonymised feedback from the previous round which included their individual choices along with their co-panellists’ views. Final consensus (in Round 3) was defined as at least 80% agreement. Commentaries on the codes from all e-Delphi rounds were pooled together and analysed thematically. Twenty-one individual panellists took part in the study (there were 12 responses in Round 1, 18 in Round 2 and 16 in Round 3). Commentaries on the codes included three themes: challenges and facilitators; level of detail; and activities related to funding. Consensus was achieved for ten codes, eight of which related to activities (general and disease specific medication reviews, monitoring of high-risk drugs and medicines reconciliation) and two to patient outcomes (presence of side effects and satisfactory understanding of medication). A formal consensus method revealed general practice-based pharmacists’ preferences for activity coding. Findings will inform policy so that any future shaping of activity coding for general practice-based pharmacists takes account of pharmacists’ actual needs and preferences.

中文翻译：

---

掌握药剂师在一般实践中的影响：一项e-Delphi研究，试图在专家之间就记录哪些活动达成共识

在英国，作为初级保健中的新医疗服务，药剂师正在不断地融入一般实践。对服务的评估涉及国家措施，这些措施要求药剂师使用电子活动代码在全科临床计算机系统上记录其工作。但是，尚未就记录哪些活动建立任何国家协议。这项研究的目的是试图就一般执业药师应记录的活动达成共识。选择e-Delphi方法是因为它是达成共识的一种出色技术。该研究从一个初始阶段开始，在该阶段中，筛选通用临床计算机系统以及与来自两个“通用药物”站点的药剂师进行的讨论小组确定了与基于通用药物的工作可能相关的81个代码。然后，通过电子邮件邀请29位专家（来自两个站点的药剂师和药学技术人员，以及通过全国委员会招募的专家）作为专家组参加了三轮e-Delphi调查问卷。在每一轮中，都要求小组成员对代码进行分级或排名，并证明其选择的合理性。在每个回合中，小组成员都会收到上一回合的匿名反馈，其中包括他们的个人选择以及共同小组成员的观点。最终共识（在第3轮中）被定义为至少80％的共识。来自所有e-Delphi回合的代码注释都汇集在一起​​，并进行了主题分析。二十一个独立的小组成员参加了该研究（第1轮共有12项回答，第2轮有18项，第3轮有16项）。对准则的评论包括三个主题：挑战与促进者；挑战与推动者。详细程度; 以及与资金相关的活动。十项法规达成了共识，其中八项与活动有关（常规和特定疾病的药物审查，高危药物的监测和药物对账），两项与患者的结局（存在副作用和对药物的满意理解）有关。正式的共识方法揭示了基于一般实践的药剂师对活性编码的偏爱。