国外药师与医师协作模型的介绍及对我国的借鉴

Introduction and Reference of Models on Collaborative Model Between Pharmacists and Physicians

目的:为构建治疗过程中我国药师与医师协作模型提供参考。方法:选取4个国外典型的药师与医师协作模型,即协作工作关系模型、全科医师与社区药师协作概念模型、社区药师对全科医师的协作态度模型/全科医师对社区药师的协作态度模型和医师与社区药师协作Meta模型,对比分析各个模型的主要观点和研究特色,初步提出我国药师与医师协作模型的框架。结果与结论:协作工作关系模型以5阶段划分协作水平,认为影响因素在不同阶段的影响程度不同;全科医师与社区药师协作概念模型以3阶段划分协作水平,认为影响因素在不同阶段表现特征不同;社区药师对全科医师的协作态度模型/全科医师对社区药师的协作态度模型分别选取社区药师、全科医师为出发点,发现部分影响因素间的关联;医师与社区药师协作Meta模型则在归纳总结的基础上遴选出重要影响因素。笔者借鉴以上模型构建了由5阶段协作水平等级即需求萌芽期、价值认同期、关系磨合期、模式强化期和关系形成期,以及3类影响因素即个人特征、从业环境特征和交互特征组成的药师与医师协作模型框架。

OBJECTIVE:To provide reference for the construction of collaborative model between pharmacists and physicians during diagnosis and treatment in China.METHODS:Four representative collaborative models between pharmacists and physicians were selected,namely,“collaborative working relationship”,“conceptual model of general practitioner and community pharmacist collaboration”,“community pharmacist attitudes towards collaboration with general practitioners/general practitioner attitudes towards collaboration with community pharmacists”and“physician-community pharmacists collaboration Meta-model”.The main points and characteristics of each model were compared and analyzed so as to put forward the framework of pharmacists and physicians collaborative model in China.RESULTS&CONCLUSIONS:Collaborative working relationship model divided the level of cooperation into five stages and considered that the effects of the factors in different stages were different.Conceptual model of general practitioner and community pharmacist collaboration divided the level of cooperation into three stages and considered that the features of the factors in different stages were different.Community pharmacist attitudes towards collaboration with general practitioners/general practitioner attitudes towards collaboration with community pharmacists chose community pharmacist or general practitioner as the starting point and found the correlation between some factors.Physician-community pharmacists collaboration Meta-model selected important factors based on the summary.Using the above models for reference,the author constructs the framework of collaborative model between pharmacists and physicians consisting of five collaboration levels,which were demand germination period,value identification period,relation run-in period,pattern strengthening period and relation formation period,and three major influenctial factors as individual characteristics,employment environment characteristics and interaction characteristics.