Competency-based and person-centred community pharmacy practice – development and implementation in Estonia

Abstract

Apteek on inimese jaoks kõige kättesaadavam tervishoiuasutus, kus ravimi- ja tervisealaspetsialistist proviisor või farmatseut pakub nii haiguste ennetamiseks kui ka ohutu ja tõhusa ravi tagamiseks vajalikku nõustamist. Sellegipoolest on elanikkonna üldine apteegiteenuste alane teadlikkus pigem madal, mida kinnitab ka 552 apteegikülastaja hulgas läbi viidud uuring. Tulemuste põhjal erinevad ravimialase nõustamise kogemused apteegis ning need, kes ei pidanud apteekrit esmaseks kontaktiks ravimitega seotud küsimustes, pöörduksid pigem perearsti poole või otsiksid infot internetist. Vähene ravimialase nõustamise kogemus apteegis mõjutas ka ootusi tulevikus erinevaid ravimialaseid teenuseid saada. Olulise probleemina tõid apteegikülastajad välja privaatsuse puudumise apteegi keskkonnas. Ka aastatel 2014, 2016 ja 2019 läbi viidud apteekide enesehindamise uuring tõi probleemina välja, et apteegis on privaatsuse tagamine patsiendi nõustamisel keeruline väljakutse. Sama uuring näitas, et apteegiteenuse osutamisel ei ole toimunud olulisi muudatusi ja mõned aastad varem apteekrite endi poolt välja töötatud „Apteegiteenuse kvaliteedijuhis“ ei ole piisaval määral rakendunud.

Kvaliteetne apteegiteenus nõuab ka erialakompetentside kaasajastamist. Ühiskonna vajaduste ja ootuste põhine õpe tuleb tagada nii eriala omandamisel ülikoolis kui ka täiendusõppes. Tartu Ülikooli proviisoriõpet on viimastel aastatel oluliselt uuendatud: rakendatud on uusi õpetamisemeetodeid, kaasajastatud on apteegipraktika korraldust ning rohkem on õpetamisprotsessidesse kaasatud tegevproviisoreid. Et suurendada üliõpilaste erialaseid teadmisi ja praktilisi oskusi ning hoida tegevproviisorite pädevust, tuleb parandada ülikooli ja farmaatsiasektori omavahelist koostööd.

Kokkuvõttes on elanikkonna kiire ja lihtne juurdepääs apteekidele ja apteekrite erialased teadmised hindamatu väärtus tervishoiule, kuid osaliselt rakendatud erialased kompetentsid ja vähene seotus tervishoiuga on apteeke tervishoiusüsteemist distantseerinud.

Community pharmacies are the most accessible health care facilities, where pharmacists and assistant pharmacists provide different services. However, the population's general awareness of what information and advice they could receive at the pharmacy could be higher. This result was confirmed by a study conducted among 552 pharmacy customers. Furthermore, it also outlined that the experience and expectations of medicines counseling in the pharmacy differ. Those who did not consider a pharmacist their primary contact for solving medicines-related problems would turn to a general practitioner or look for information on the Internet. The limited experience in medicines counseling in the pharmacy also affected the expectations of receiving different medicines-related services in the future. The lack of privacy in the pharmacy was also often considered an obstacle to more comprehensive communication with the pharmacist.

The pharmacy self-evaluation survey conducted in 2014–2019 also pointed out that ensuring privacy in a pharmacy is a difficult challenge. The same study outlined that there has been no significant change in the quality of pharmacy services, although the "Community Pharmacy Services Quality Guidelines" was introduced in 2012.

The development of pharmacy services also requires a change in professional competencies. Education, based on the needs and expectations of society, must be ensured both at the university and in continuing professional education. In recent years, pharmacy education at the University of Tartu has undergone many updates: new teaching methods, restructured pharmacy practice, and more practitioners have been involved in teaching. In order to increase the professional knowledge and practical skills of pharmacy students and to maintain the competence of working pharmacists, the cooperation between the university and the pharmaceutical sector must be improved.

In summary, people's convenient access to pharmacies and the professional knowledge of pharmacists are invaluable assets to healthcare, but partially used professional competencies and little involvement with health care have distanced pharmacies from health care system.