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首页> 外文期刊>BMC Public Health >Effect of medication review and cognitive behaviour treatment by community pharmacists of patients discharged from the hospital on drug related problems and compliance: design of a randomized controlled trial
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Effect of medication review and cognitive behaviour treatment by community pharmacists of patients discharged from the hospital on drug related problems and compliance: design of a randomized controlled trial

机译：出院患者的社区医师对药物审查和认知行为治疗对药物相关问题和依从性的影响：一项随机对照试验的设计

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Background Drug related problems (DRPs) are common among elderly patients who are discharged from the hospital and are using several drugs for their chronic diseases. Examples of drug related problems are contra-indications, interactions, adverse drug reactions and inefficacy of treatment. Causes of these problems include prescription errors and non-compliance with treatment. The aim of this study is to examine the effect of medication review and cognitive behaviour therapy of discharged patients by community pharmacists to minimize the occurrence of drug related problems. Methods/Design A randomized controlled trial will be performed. Community pharmacists will be randomized into a control group and an intervention group. 342 Patients, aged over 60 years, discharged from general and academic hospitals, using five or more prescription drugs for their chronic disease will be asked by their pharmacy to participate in the study. Patients randomized to the control group will receive usual care according to the Dutch Pharmacy Standard. The medication of patients randomised to the intervention group will be reviewed by the community pharmacist with use of the national guidelines for the treatment of diseases, when patients are discharged from the hospital. The Pharmaceutical Care network Europe Registration form will be used to record drug related problems. Trained pharmacy technicians will counsel patients at home at baseline and at 1,3,6,9 and 12 months, using Cognitive Behaviour Treatment according to the Theory of Planned Behaviour. The patient's attitude towards medication and patient's adherence will be subject of the cognitive behaviour treatment. The counselling methods that will be used are motivational interviewing and problem solving treatment. Patients adherence towards drug use will be determined with use of the Medication Adherence Report Scale Questionnaire. There will be a follow-up of 12 months. The two primary outcome measures are the difference in occurrence of DRPs between intervention and control group and adherence with drug use. Secondary endpoints are attitude towards drug use, incidence of Re-hospitalisations related to medicines, functional status of the patient, quality of life and the cost-effectiveness of this intervention. Discussion Combining both medication review and Cognitive Behaviour Treatment may decrease DRPs and may result in more compliance with drug use among patients discharged from the hospital and using 5 or more chronic drugs. Trial registration Dutch Trial Register NTR1194
机译：背景药物相关问题（DRP）在出院并正在使用几种药物治疗慢性病的老年患者中很常见。药物相关问题的例子有禁忌症，相互作用，药物不良反应和治疗无效。这些问题的原因包括处方错误和不遵守治疗规定。这项研究的目的是检验社区药剂师对出院患者进行药物复审和认知行为疗法的效果，以最大程度地减少与药物有关的问题的发生。方法/设计将进行一项随机对照试验。社区药剂师将被随机分为对照组和干预组。 342名年龄在60岁以上，从综合医院和学术医院出院，使用五种或更多种慢性疾病处方药的患者将被药房要求参加研究。随机分为对照组的患者将根据荷兰药房标准接受常规护理。当患者出院时，将由社区药剂师根据国家疾病治疗指南对随机分配给干预组的患者的药物进行审查。药品护理网络欧洲注册表格将用于记录与药物相关的问题。受过训练的药房技术人员将根据计划行为理论，使用认知行为治疗在基线，1、3、6、9和12个月在家指导患者。患者对药物的态度和患者的依从性将成为认知行为治疗的主题。将使用的辅导方法是动机性面试和解决问题的方法。患者对药物使用的依从性将通过《药物依从性报告量表》进行确定。将进行12个月的随访。两项主要的结局指标是干预组和对照组之间DRP发生的差异以及对药物使用的依从性。次要终点是对药物使用的态度，与药物有关的再次住院发生率，患者的功能状况，生活质量和该干预措施的成本效益。讨论将药物复习和认知行为治疗相结合可以减少DRP，并可能导致出院并使用5种或5种以上慢性药物的患者对药物使用的依从性更高。试用注册荷兰试用注册NTR1194

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