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首页> 外文期刊>Journal of the American Pharmaceutical Association: APhA >Pharmaceutical care research and education project: pharmacists' interventions.
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Pharmaceutical care research and education project: pharmacists' interventions.

机译：药物护理研究和教育项目：药剂师的干预。

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OBJECTIVES: To describe the processes of care used by community pharmacists participating in the Pharmaceutical Care Research and Education Project (PREP) in terms of drug-related problems (DRPs), pharmacists' recommendations, and status of DRPs at follow-up, and to determine characteristics associated with DRPs. DESIGN: Descriptive analysis of the treatment group from a larger randomized, controlled cluster design. SETTING: Five independent community pharmacies in Alberta. PARTICIPANTS: One hundred fifty-nine patients who were covered under Alberta Health and Wellness's senior drug benefit plan (i.e., 65 years or older), were taking three or more medications concurrently according to pharmacy records, were able to complete telephone interviews as determined by pharmacists, maintained residence in Alberta for 12 of the 15 study months, agreed to receive their prescription medications only from the study pharmacy during the study period, and provided informed consent. MAIN OUTCOME MEASURES: Frequency ofDRPs, recommendations, status of DRPs, and analysis of clinical results as determined during pharmacists' follow-up care. RESULTS: In telephone surveys, patients reported taking 4.7 prescription medications per day, but pharmacists documented 8.7 prescription medications per day in their records. Pharmacists documented 559 DRPs, a mean (+/- SD) of 3.9+/-3.2 problems per patient. Approximately 39% of problems were actual DRPs, while 60% were potential DRPs. Medical conditions associated most frequently with a DRP involved the respiratory, cardiovascular, and musculoskeletal systems. The most common DRP categories were "patient requires drug therapy" or "patient requires influenza or pneumococcal vaccination." Pharmacists wrote 551 initial clinical notes using the subjective, objective, assessment, plan (SOAP) format, and they recorded 346 follow-up interventions, also using SOAP notes. Counseling, preventive consultations, and clinical monitoring represented 40% of their recommendations. In 80% of situations, the pharmacist made the recommendation directly to the patient. On follow-up, 40% of the 559 DRPs identified were resolved, controlled, or improved. Patients accepted 76% of pharmacists' recommendations, and physicians accepted 72% of pharmacists' suggested resolutions of DRPs. Pharmacists were more likely to follow up about actual DRPs, as compared with potential ones; overall, they followed up on 62% of identified DRPs. CONCLUSION: Pharmacists identified more DRPs for study patients than previous community-based, observational studies have reported. Undertreatment appears to be a prevalent DRP. Community pharmacists' recommendations to prevent and resolve DRPs were made primarily to patients and were well accepted. More follow-up was needed for all DRPs. When follow-up occurred, the DRP results generally showed improvement.
机译：目的：从药物相关问题（DRP），药剂师的建议以及后续行动中DRP的状态来描述参与药物护理研究与教育项目（PREP）的社区药剂师所采用的护理过程，并确定与DRP相关的特征。设计：对治疗组的描述性分析来自一个较大的随机，受控簇设计。地点：艾伯塔省的五个独立社区药店。参与者：阿尔伯塔健康与健康部高级药物福利计划（即65岁或65岁以上）涵盖的159名患者根据药房记录同时服用三种或三种以上药物，能够完成电话采访，具体取决于药剂师在15个研究月中的12个月内一直在艾伯塔省居住，他们同意在研究期间仅从研究药房获得处方药，并提供了知情同意。主要观察指标：药师随访期间确定的DRP频率，建议，DRP状态和临床结果分析。结果：在电话调查中，患者报告每天服用4.7种处方药，但药剂师在记录中记录了每天8.7种处方药。药剂师记录了559个DRP，每位患者平均（+/- SD）出现3.9 +/- 3.2个问题。大约39％的问题是实际的DRP，而60％是潜在的DRP。与DRP最频繁相关的医学状况涉及呼吸系统，心血管系统和肌肉骨骼系统。最常见的DRP类别是“患者需要药物治疗”或“患者需要流感或肺炎球菌疫苗接种”。药剂师使用主观，客观，评估，计划（SOAP）格式编写了551份初始临床笔记，并且他们还使用SOAP笔记记录了346项后续干预措施。咨询，预防性咨询和临床监测占建议的40％。在80％的情况下，药剂师直接向患者提出了建议。随访后，确定的559种DRP中有40％得到解决，控制或改善。患者接受了76％的药剂师建议，而医生接受了72％的药剂师建议的DRP解决方案。与潜在的DRP相比，药剂师更可能跟进实际的DRP。总体而言，他们跟踪了62％的已确定DRP。结论：药剂师为研究患者确定的DRP比以前基于社区的观察性研究报告的要多。处理不足似乎是普遍的DRP。社区药剂师关于预防和解决DRP的建议主要针对患者，并得到了广泛接受。所有DRP都需要更多的跟进。当进行随访时，DRP结果通常显示出改善。

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