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首页> 外文期刊>Journal of Clinical Pharmacy and Therapeutics >Pharmaceutical care issues encountered by post-menopausal osteoporotic women prescribed bisphosphonates
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Pharmaceutical care issues encountered by post-menopausal osteoporotic women prescribed bisphosphonates

机译：绝经后骨质疏松妇女开具双膦酸盐类药物时遇到的药物护理问题

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What is known and Objective: Pharmacists have been involved in providing comprehensive interventions to osteoporosis patients, but pharmaceutical care issues (PCIs) encountered during such interventions have not been well documented. Therefore, the aim of this study was to document PCIs encountered by post-menopausal osteoporotic women prescribed bisphosphonates. Methods: A randomized controlled study was conducted from September 2005-February 2009 in the University Malaya Medical Centre, Malaysia. This main intervention study measured the effects of pharmaceutical care on medication adherence, persistence, quality of life, knowledge and patient satisfaction. However, this manuscript is part of the main intervention study and focuses only on the PCIs encountered. Inclusion criteria: post-menopausal women diagnosed with osteoporosis (T-score≤-2.5/low-trauma fracture) and prescribed weekly alendronate/risedronate. Exclusion criteria: those with metabolic bone disease and could not communicate in English. The PCIs identified were collected via personal interviews or telephone calls, and each participant was followed-up for a period of 2 years. All PCIs were discussed with and confirmed by a physician. Results and Discussion: Of the 198 participants recruited, 64 (32.3%) experienced adverse effects because of bisphosphonates whereas one participant (0.5%) refused to start bisphosphonates because of fear of adverse effects. Most adverse effects [50 (74.6%)] were reported during the first 3 months of therapy with gastrointestinal problems being the main issue [23 (11.6%)]. Of the nine participants (4.5%) who discontinued bisphosphonates, only three agreed to take another medication. From the 97 PCIs identified, 77 issues could be classified as drug-related problems [according to the Pharmaceutical Care Network Europe Classification v6.2]. There were 87 causes, 178 interventions and 77 outcomes. The main problem and cause of the PCIs encountered were adverse drug events (83.1% and 74.7% respectively), whereas the main intervention provided was patient counselling (41.0%). All problems were solved (98.5%) except for one because of the lack of cooperation of a patient. After 2 years, 36 participants (20%) were no longer persistent with therapy, 19 (10.6%) did not have clinic follow-up and 53 (26.8%) did not have a bone mineral density scan. What is new and Conclusion: The main PCIs identified were related to the use of bisphosphonates and its adverse effects. The study showed that the presence of a clinical pharmacist has enabled patients to voice their medication-related issues and to allow appropriate recommendations and actions to be taken to resolve these issues.
机译：已知和目的：药剂师已参与为骨质疏松症患者提供全面的干预措施，但是在此类干预措施中遇到的药物护理问题（PCI）尚未得到充分记录。因此，本研究的目的是记录绝经后骨质疏松妇女开具双膦酸盐类药物所遇到的PCI。方法：2005年9月至2009年2月在马来西亚马来亚大学医学中心进行了一项随机对照研究。这项主要的干预研究测量了药物治疗对药物依从性，持久性，生活质量，知识和患者满意度的影响。但是，该手稿是主要干预研究的一部分，仅关注所遇到的PCI。纳入标准：绝经后妇女，被诊断出患有骨质疏松症（T分数≤-2.5/低创伤性骨折），并每周开处方阿仑膦酸钠/艾塞膦酸钠。排除标准：患有代谢性骨病且无法用英语交流的人。通过个人访谈或电话收集确定的PCI，并对每个参与者进行为期2年的随访。与医生讨论并确认了所有PCI。结果与讨论：在所招募的198名参与者中，有64名（32.3％）由于双膦酸盐类药物而产生不良反应，而一名参与者（0.5％）由于担心不良反应而拒绝使用双膦酸盐类药物。在治疗的前三个月中报告了大多数不良反应[50（74.6％）]，其中以胃肠道问题为主要问题[23（11.6％）]。停用双膦酸盐类药物的9名参与者（4.5％）中，只有3名同意服用另一种药物。在确定的97个PCI中，有77个问题可以归类为与药物相关的问题[根据《欧洲药品护理网络分类v6.2》。有87个原因，178个干预措施和77个结果。遇到PCI的主要问题和原因是药物不良事件（分别为83.1％和74.7％），而提供的主要干预措施是患者咨询（41.0％）。除一个问题外，由于患者缺乏合作，所有问题均得到解决（98.5％）。 2年后，36名参与者（20％）不再坚持治疗，19名（10.6％）没有进行临床随访，53名（26.8％）没有进行骨矿物质密度扫描。新内容和结论：确定的主要PCI与双膦酸盐的使用及其副作用有关。研究表明，临床药剂师的存在使患者能够表达与药物有关的问题，并允许采取适当的建议和行动来解决这些问题。

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