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Knowledge exchange between patient and pharmacist: A mixed methods study to explore the role of pharmacists in patient education and counseling in asthma and pulmonary arterial hypertension - 03/01/23

Échanges de savoirs entre le patient et le pharmacien : une étude mixte pour explorer le rôle des pharmaciens dans l’éducation et le conseil dans l’asthme et l’hypertension artérielle pulmonaire

Doi : 10.1016/j.pharma.2022.06.005 
S. Renet a, b, , M.-C. Chaumais c, d, e, M. Gallant-Dewavrin f, E. Jouet g, h, Y. Bezie a, M. Humbert e, i, j, A. Rieutord k, O. Las Vergnas b
a Paris Saint-Joseph Hospital Group, Pharmacy Department, Paris, France 
b University of Paris Nanterre, Education and Training Research Center (ED 139 - EA 1589), Nanterre, France 
c Paris-Sud University, Faculty of Pharmacy, Chatenay-Malabry, France 
d Bicêtre Hospital, Pharmacy Department, Le Kremlin-Bicêtre, France 
e Inserm UMR_S 999, Marie-Lannelongue Hospital, Le Plessis-Robinson, France 
f HTaPFrance, Association of Patients, Caregivers and Lung Transplants, Paris, France 
g Research in Human, Social and Mental Health Laboratory, GHU Paris Psychiatrie & Neurosciences, Maison-Blanche, Paris, France 
h Education Ethics Health (EA7505), Tours University, Tours, France 
i Paris-Saclay University, Paris, France 
j Kremlin-Bicêtre Hospital, Department of Respiratory and Intensive Care Medicine, Le Kremlin-Bicêtre, France 
k Gustave-Roussy Cancer Campus, Pharmacy Department, Villejuif, France 

Corresponding author at: Groupe Hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France.Groupe Hospitalier Paris Saint-Joseph185, rue Raymond-LosserandParis75014France

Highlights

Pharmacy practice has evolved from drug distribution to education.
Chronic patients acquire knowledge from experience of the disease and the healthcare system.
Chronic patients are often unaware of the educational role of pharmacists.
Knowledge exchange covers 4 dimensions: cure, care, coordination/supply chain, pathophysiology.
An informal two-way education exists between respiratory patients and pharmacists.

Il testo completo di questo articolo è disponibile in PDF.

Summary

Objectives

To better understand the role of pharmacists in patient education and counselling: describe the perception of knowledge exchange (KE) between asthma/pulmonary arterial hypertension patients and pharmacists (hospital/community) according to four dimensions (4C-typology): cure (C1), care (C2); coordination/supply chain (C3), characteristics of the pathophysiology/disease mechanisms (C4); factors correlated with KE.

Methods

A mixed methods approach was used. Part A: data from semi-structured patient interviews were processed (thematic analysis), and a questionnaire developed. Part B: completed patient questionnaires were processed by correspondence factor analysis.

Results

KE (4C-typology) was correlated with pathology, disease severity, disease duration, age, hospital/community pharmacist. Patients expected pharmacists to provide C2/C3 services. KE with pharmacists covered C1/C2/C3, and with physicians, C1/C2/C4. While patients perceived KE as a means of self-learning to improve self-care skills, the two-way nature meant it provided specific experiential information feedback to pharmacists.

Conclusions

This 4C-typology provides a holistic framework for optimising the pharmacists’ role in education and counselling of patients with chronic diseases.

Il testo completo di questo articolo è disponibile in PDF.

Résumé

Objectifs

Mieux comprendre le rôle des pharmaciens dans l’éducation et le conseil aux patients : décrire la perception de l’échange de savoirs (EC) entre les patients asthmatiques/hypertension artérielle pulmonaire et les pharmaciens (hospitalier/officine) selon quatre dimensions (typologie 4C) : cure (C1), soins (C2) ; coordination/chaîne d’approvisionnement (C3), caractéristiques de la physiopathologie/mécanismes de la maladie (C4) ; facteurs corrélés avec KE.

Méthodes

Une méthode mixte a été utilisée. Partie A : les entretiens semi-structurés avec les patients ont été traités via une analyse thématique puis un questionnaire a été élaboré. Partie B : les questionnaires des patients ont été traités par analyse factorielle des correspondances.

Résultats

L’EC (typologie 4C) était corrélée avec la pathologie, la gravité de la maladie, la durée de la maladie, l’âge, le pharmacien hospitalier/officine. Les patients s’attendaient à ce que les pharmaciens fournissent des services C2/C3. Les EC avec les pharmaciens étant de nature C1/C2/C3, et avec les médecins, C1/C2/C4. Alors que les patients percevaient l’EC comme un moyen d’auto-apprentissage pour améliorer les compétences d’auto-soins, la nature bidirectionnelle de l’EC montrait un retour de savoirs expérientiels spécifiques du patient vers les pharmaciens.

Conclusions

Cette typologie des 4C fournit un cadre holistique pour optimiser le rôle des pharmaciens dans l’éducation et le conseil des patients atteints de maladies chroniques.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : Chronic care, Education and counselling, Pharmaceutical care, Mixed methods, Correspondence analysis

Mots clés : Soins chroniques, Éducation et conseil, Soins pharmaceutiques, Méthodes mixtes, Analyse des correspondances


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