Exploring the role of community pharmacists in perioperative management of antithrombotic agents: a qualitative study of barriers, facilitators, and future directions.
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| Název: | Exploring the role of community pharmacists in perioperative management of antithrombotic agents: a qualitative study of barriers, facilitators, and future directions. |
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| Autoři: | Capiau A; Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000, Ghent, Belgium. Andreas.Capiau@UGent.be.; Department of Pharmacy, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium. Andreas.Capiau@UGent.be., Kint I; Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000, Ghent, Belgium., Mehuys E; Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000, Ghent, Belgium., De Backer T; Department of Cardiology, Heart Centre, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium.; Department of Internal Medicine and Paediatrics, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium., Somers A; Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000, Ghent, Belgium.; Department of Pharmacy, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium., Boussery K; Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000, Ghent, Belgium. |
| Zdroj: | International journal of clinical pharmacy [Int J Clin Pharm] 2025 Dec; Vol. 47 (6), pp. 1852-1860. Date of Electronic Publication: 2025 Aug 30. |
| Způsob vydávání: | Journal Article |
| Jazyk: | English |
| Informace o časopise: | Publisher: Springer Country of Publication: Netherlands NLM ID: 101554912 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2210-7711 (Electronic) NLM ISO Abbreviation: Int J Clin Pharm Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Dordrecht : Springer |
| Výrazy ze slovníku MeSH: | Pharmacists*/trends , Fibrinolytic Agents*/adverse effects , Fibrinolytic Agents*/administration & dosage , Fibrinolytic Agents*/therapeutic use , Perioperative Care*/methods , Perioperative Care*/trends , Professional Role* , Community Pharmacy Services*/trends , Community Pharmacy Services*/organization & administration, Humans ; Female ; Male ; Middle Aged ; Qualitative Research ; Adult ; Belgium |
| Abstrakt: | Competing Interests: Declarations. Competing interests: The authors declare no conflicts of interest. Ethics approval: This study was approved by the Ethics Committee of Ghent University Hospital (B6702024000034) on 15 January 2024. Consent to participate: All participants gave written informed consent before being interviewed. Introduction: Antithrombotic agents are considered as high-risk medications, particularly during the perioperative period, because of the increased risk of bleeding. Balancing bleeding and thrombosis risks is crucial in the context of invasive procedures. The specific role of community pharmacists (CPs) in perioperative antithrombotic management remains unclear. Aim: This study aimed to explore the role of CPs in perioperative antithrombotic management, focusing on their experiences, and the barriers and facilitators to expand their involvement. Method: A qualitative study was conducted in Belgium between March and May 2024 using semi-structured, in-depth interviews with CPs. The Theoretical Domains Framework guided the development of the interview guide to ensure comprehensive coverage of relevant domains. Interviews were transcribed verbatim and analysed thematically using open and axial coding in NVivo 14 by two independent researchers. Participants were randomly sampled and recruited until no new themes were generated. Results: A total of 13 CPs (7 female; median age 48 years, IQR 34-58) participated in the in-depth interviews. Four key themes emerged: (i) current involvement of CPs in perioperative antithrombotic management, (ii) factors influencing CPs' role, (iii) aspirations and perceived opportunities for role expansion, and (iv) proposed strategies to optimise CPs' contributions. CPs described their current role as limited and mainly reactive, with their involvement typically occurring postoperatively. Reported barriers included insufficient knowledge of antithrombotic protocols, time constraints, inconsistent and non-transparent hospital guidelines, lack of access to relevant medical records, and difficulty reaching hospital-based prescribers. Facilitators included CPs' unique position to oversee a patient's full medication regimen, strong and trusted patient relationships, early post-discharge contact, and intrinsic motivation to contribute more actively. Participants expressed a desire for more proactive and collaborative involvement, supported by structured training. They also stressed the importance of clear, well-accessible guidelines that are as uniform as possible across hospitals. Lastly, they emphasised the need for better accessibility to prescribers to facilitate more effective communication. Conclusion: CPs' role in perioperative antithrombotic management is currently limited, particularly preoperatively. Addressing identified barriers and implementing the suggested improvements could strengthen their role. Further research is needed to validate these findings and guide future interventions. (© 2025. The Author(s), under exclusive licence to Springer Nature Switzerland AG.) |
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| Contributed Indexing: | Keywords: Antithrombotic agents; Community pharmacy services; Perioperative care; Qualitative research |
| Substance Nomenclature: | 0 (Fibrinolytic Agents) |
| Entry Date(s): | Date Created: 20250830 Date Completed: 20251119 Latest Revision: 20251119 |
| Update Code: | 20251119 |
| DOI: | 10.1007/s11096-025-01985-1 |
| PMID: | 40884687 |
| Databáze: | MEDLINE |
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Nájsť tento článok vo Web of Science | Abstrakt: | Competing Interests: Declarations. Competing interests: The authors declare no conflicts of interest. Ethics approval: This study was approved by the Ethics Committee of Ghent University Hospital (B6702024000034) on 15 January 2024. Consent to participate: All participants gave written informed consent before being interviewed.<br />Introduction: Antithrombotic agents are considered as high-risk medications, particularly during the perioperative period, because of the increased risk of bleeding. Balancing bleeding and thrombosis risks is crucial in the context of invasive procedures. The specific role of community pharmacists (CPs) in perioperative antithrombotic management remains unclear.<br />Aim: This study aimed to explore the role of CPs in perioperative antithrombotic management, focusing on their experiences, and the barriers and facilitators to expand their involvement.<br />Method: A qualitative study was conducted in Belgium between March and May 2024 using semi-structured, in-depth interviews with CPs. The Theoretical Domains Framework guided the development of the interview guide to ensure comprehensive coverage of relevant domains. Interviews were transcribed verbatim and analysed thematically using open and axial coding in NVivo 14 by two independent researchers. Participants were randomly sampled and recruited until no new themes were generated.<br />Results: A total of 13 CPs (7 female; median age 48 years, IQR 34-58) participated in the in-depth interviews. Four key themes emerged: (i) current involvement of CPs in perioperative antithrombotic management, (ii) factors influencing CPs' role, (iii) aspirations and perceived opportunities for role expansion, and (iv) proposed strategies to optimise CPs' contributions. CPs described their current role as limited and mainly reactive, with their involvement typically occurring postoperatively. Reported barriers included insufficient knowledge of antithrombotic protocols, time constraints, inconsistent and non-transparent hospital guidelines, lack of access to relevant medical records, and difficulty reaching hospital-based prescribers. Facilitators included CPs' unique position to oversee a patient's full medication regimen, strong and trusted patient relationships, early post-discharge contact, and intrinsic motivation to contribute more actively. Participants expressed a desire for more proactive and collaborative involvement, supported by structured training. They also stressed the importance of clear, well-accessible guidelines that are as uniform as possible across hospitals. Lastly, they emphasised the need for better accessibility to prescribers to facilitate more effective communication.<br />Conclusion: CPs' role in perioperative antithrombotic management is currently limited, particularly preoperatively. Addressing identified barriers and implementing the suggested improvements could strengthen their role. Further research is needed to validate these findings and guide future interventions.<br /> (© 2025. The Author(s), under exclusive licence to Springer Nature Switzerland AG.) |
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| ISSN: | 2210-7711 |
| DOI: | 10.1007/s11096-025-01985-1 |