建構健康促進友善社區藥局：藥師和顧客的觀點

目標：此研究旨在探索建立健康促進社區藥局的可行性，以讓藥師於社區中可以提供友好和專業的健康促進服務。方法：本計畫進行台灣中部地區連鎖、門前及獨立社區藥局之共六名執業藥師及六名訪客之半結構式訪談及多次專家會議，所獲得的資料經描述性與演繹式主題分析，綜合比較研究結果後，擬出社區藥局執行健康促進（健促）的作業流程及執業藥師的自我檢核表草案，以供日後在實施時參考。結果：社區藥局因型態不同導致服務內容差異甚大，多以調劑為主，其中獨立藥局在藥事照護及其他健促服務的配合度上最高。民眾對藥師的專業服務的認同，藥師提供健促的專業訓練、政府的給付、作業流程及自我評核的建立是推動健促社區藥局的最大挑戰。結論：後疫情時代，建議由獨立藥局或有意願的社區藥局藥師以戒菸諮詢之初始架構，加以政府支持以作為發展健促社區藥局執業模式之參考；在與新冠病毒共存之時，以利於在社區中可以提供高品質的健康促進與用藥安全之健康照護。

Objectives: This study was conducted to explore a viable model for establishing health-promoting community pharmacies in Taiwan, where pharmacists can provide amiable and professional health promotion services within a community environment. Methods: Semi-structured interviews were conducted with six licensed pharmacists and six customers hailing from chain, non-owner-managed, and independent community pharmacies in central Taiwan. Following these interviews, several expert meetings were scheduled to discuss the collected information. The obtained data were analyzed through deductive content analysis, utilizing descriptive, in vivo, and pattern coding techniques. Drawing upon the insights gleaned from our analysis, we formulated standard operating procedures and a self-assessment performance checklist for pharmacists, with the ultimate goal of enhancing health promotion in community settings. Results: The services, which primarily centered around dispensing medications, exhibited variation across the included community pharmacies. Independent pharmacies demonstrated the highest level of cooperation in delivering pharmaceutical care and other health promotion services. The primary hurdles in the pursuit of health promotion revolved around gaining public recognition, facilitating professional training for pharmacists, securing government funding, and developing pertinent standard operating procedures and self-assessment checklists. Conclusions: We recommend the incorporation of independent pharmacies and pharmacists who are enthusiastic about engaging in community pharmacy initiatives. The proposed model can seamlessly integrate into the current framework of smoking cessation services, provided it receives adequate government support. Given the challenges arising in the post-pandemic period, our study has the potential to advance the delivery of high-quality primary care to community-based patients in Taiwan, with a focus on health promotion and ensuring safe medication use.