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首页> 外文期刊>Scandinavian journal of primary health care. >General practitioners’ and nurses’ views on medication reviews and potentially inappropriate medicines in elderly patients – a qualitative study of reports by educating pharmacists
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General practitioners’ and nurses’ views on medication reviews and potentially inappropriate medicines in elderly patients – a qualitative study of reports by educating pharmacists

机译：全科医生和护士对老年患者的药物评论和可能不适当的药物的看法–通过对药剂师的教育进行的定性研究

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Objective: The aim with this study was to understand more about how general practitioners (GPs) and nurses in primary care experience their work with medication reviews in elderly patients. Design: This qualitative study was nested within a cluster randomised trial and analysed narrative and unstructured diaries written by two pharmacists who performed academic detailing, i.e. educational outreach visits in primary care. The educational sessions dealt with potentially inappropriate medicines, and stimulated interprofessional dialogue in relation to medication reviews. The purpose of the diaries was to document and structure the pedagogical process of academic detailing and contained quotes from 194 GP and 113 nurse participants in the sessions, and the pharmacists’ reflections. The data was explored using thematic analysis. Setting: Thirty-three primary care practices in Stockholm, Sweden. Subjects: GPs and nurses working in primary care. Main outcome measures: Thematic descriptions of academic detailing by pharmacists. Results: Five themes were identified: 1) Complexity in 3 ‘P’: patients, pharmacotherapy, and primary care; 2) What, when, who? Clash between GPs’ and nurses’ experiences and guidelines; 3) Real-world problems and less-than-ideal solutions; 4) Eureka? Experiences with different steps during a medication review; and 5) Threats to GP autonomy. Conclusion: GPs and nurses should participate in the construction and release of guidelines in order to increase their usability in clinical practice. Future research should analyse if alternative strategies such as condensed medical reviews and feedback on prescribing are easier to implement in primary care. Key points Complex medication reviews have been introduced on a large scale in Swedish primary care, but knowledge on GPs’ and nurses’ views on such reviews is lacking. In the context of primary care alternative strategies such as condensed medication reviews and feedback on prescribing may be more applicable than medication reviews according to guidelines. GPs and nurses should make contributions to the development of guidelines on medication reviews in order to increase their usability in clinical practice.
机译：目的：本研究的目的是更多地了解全科医生（GPs）和初级保健护士如何通过老年患者的药物审查体验他们的工作。设计：该定性研究被嵌套在一项随机试验中，并分析了两位药剂师撰写的叙述性和非结构化日记，这些药剂师进行了学术研究，即在初级保健中进行教育外访。教育会议处理可能不适当的药物，并促进了与药物审查有关的专业间对话。日记的目的是记录和构造学术细节的教学过程，并包含194名全科医生和113名护士参加会议的名言以及药剂师的反思。使用主题分析来探索数据。地点：瑞典斯德哥尔摩的33种初级保健实践。受试者：基层医疗的全科医生和护士。主要结果度量：药剂师对学术细节的主题描述。结果：确定了五个主题：1）3个“ P”的复杂性：患者，药物治疗和初级保健; 2）什么，什么时候，谁？全科医生和护士的经验和准则之间的冲突; 3）现实问题和不理想的解决方案; 4）尤里卡？药物审核过程中不同步骤的经验; 5）对GP自治的威胁。结论：全科医生和护士应参与指南的制定和发布，以增加他们在临床实践中的可用性。未来的研究应分析是否可以在基层医疗中更容易实施替代策略，例如简明医学评论和处方反馈。重点在瑞典的初级保健中已广泛采用了复杂的药物评价，但是缺乏有关全科医生和护士对此类评价的了解。在初级保健的背景下，替代药物的策略，例如浓缩药物评论和处方反馈，可能比根据指南的药物评论更适用。全科医生和护士应为药物审查指南的制定做出贡献，以增加他们在临床实践中的可用性。

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