The development of community pharmacy services in Estonia - public and professional perceptions 1993-2006

Date

2010-11-04

Authors

Volmer, Daisy

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Abstract

Eestis kehtiva farmaatsiaseadusandluse kohaselt on reguleeritud nõuded apteegiruumidele, seal töötavatele inimestele ja apteegikaupadele (ravimid), kuid puuduvad eeskirjad apteegiteenuse kvaliteedi tagamiseks ja arendamiseks. Doktoriväitekiri selgitas apteegiteenuse arengut aastatel 1993-2006, kasutades nii avalikku kui ka erialaspetsialistide (proviisorite) arvamust. Avalik arvamus oli aluseks apteekide ühiskondliku kuvandi ja apteegis toimuva käsimüügiravimite- ning iseravimisealase nõustamise hindamisel. Proviisorite arvamust vaadeldi apteegis osutatavate lisateenuste ja apteegis toimuva ravimiohutuse tagamise selgitamiseks. Perioodil 1993-2005 paranes nii apteegiteenuse kättesaadavus kui ka kvaliteet. Apteeke kirjeldati kui kaasaegseid tervishoiuasutusi, kus pakuti patsiendikeskset ravimitealast nõustamist. Proviisoreid peeti usaldusväärseks teabeallikaks ravimite ja kergemate haiguste alase nõustamise osas. Sarnaselt oma Põhjamaade kolleegidega avastasid ja lahendasid Eesti proviisorid oma igapäevatöös ravimiretseptidega seotud probleeme ja takistasid sellega ravimi ebasoovitavate ja patsiendi elu ohustavate toimete ilmnemist. Siiski ei olnud kõik apteegikülastajad alati rahul apteegis pakutud teenuse kvaliteediga. Rahulolematus võis olla tingitud apteegist saadud ebapiisava ravimiinformatsiooniga. Lisaks ootasid apteegikülastajad enam konkreetsele patsiendile suunatud teenust. Taimsete preparaatide alasel nõustamisel võib tõenduspõhise informatsiooni puudumine mõnikord takistada patsiendile piisava teabe pakkumist. Apteegikülastajate ootused apteegis pakutavate lisateenuste osas olid madalad. Vähe osati soovida ravimite korrektse kasutamise ja ravi tõhususe jälgimist proviisori poolt. Eelneva kogemuse puudumise tõttu ei näe Eesti patsiendid apteeki kohana, kus võiks toimuda patsientide ravimite kasutamise jälgimine, mis omakorda parandaks oluliselt medikamentoosse ravi kvaliteeti.
The current pharmacy legislation in Estonia outlines standards for pharmacy premises, personnel and medicines. However, the legislation does not outline standards or provide guidance concerning the provision of community pharmacy services. This thesis evaluated the development of community pharmacy services in Estonia between 1993 and 2006. The thesis investigated opinions of the general public and community pharmacists. Specific objectives were to investigate the public image of community pharmacists as providers of counselling about over-the-counter medicines, and to investigate self-medication of minor illnesses. The professional role of pharmacists in assuring drug safety was also assessed. The quality and accessibility of community pharmacy services improved between 1993 and 2005. Community pharmacies were described as contemporary health care institutions providing patient-centred services. Community pharmacists were frequently used sources of drug information and counselling about minor illnesses. Similarly to pharmacists in the Nordic countries, Estonian community pharmacists identified and resolved prescription errors and prevented prescription errors turning into adverse drug events that may endanger patients’ lives. Some pharmacy customers were not always satisfied with services provided at community pharmacies. Dissatisfaction may be partly attributed to pharmacists not providing sufficient drug information. In addition, pharmacy customers expected pharmacists to provide services more oriented to the needs of particular patients. Some pharmacists perceived that there was a lack of evidence-based information available to provide counselling about herbal products. There was a low public expectation to receive extended services at community pharmacies. Pharmacists were not expected to monitor drug treatment. This may because pharmacy customers were unaware that community pharmacy services may improve the quality of drug treatment.

Description

Väitekirja elektrooniline versioon ei sisalda publikatsioone.

Keywords

doktoritööd, meditsiin, apteegid, apteekrid, farmaatsia, avalik arvamus

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