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首页> 外文期刊>The International journal of pharmacy practice >Clinical and cost effectiveness of a multi-professional medication reviews in care homes (CAREMED)
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Clinical and cost effectiveness of a multi-professional medication reviews in care homes (CAREMED)

机译：在护理家庭（Caremed）中多职业药物评论的临床和成本效果

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Objectives With 70% of care home residents experiencing a medication error every day in the UK, better multi-professional working between medical practitioners, pharmacists and care homes was recommended. The aim of this study was to determine the effectiveness (falls reduction) and cost-effectiveness, of a multi-professional medication review (MPMR) service in care homes for older people. Method A total of care homes in the East of England were cluster randomised to 'usual care' or two multi-professional (General practitioner, clinical pharmacist and care homes staff) medication reviews during the 12-month trial period. Target recruitment was 900 residents with 10% assumed loss to follow-up. Co-primary outcome measures were number of falls and potentially inappropriate prescribing assessed by the Screening Tool of Older Persons Prescriptions. Key findings A total of 826 care home residents were recruited with 324 lost to follow-up for at least one primary outcome measure. The mean number of falls per resident per annum was 3.3 for intervention and 3.0 for control (P = 0.947). Each resident was found to be prescribed 0.69 (intervention) and 0.85 (control) potentially inappropriate medicines after 12 months (P = 0.046). No significant difference identified in emergency hospital admissions or deaths. Estimated unadjusted incremental mean cost per resident was 374.26 pound higher in the intervention group. Conclusions In line with other medication review based interventions in care homes, two MPMRs improved medication appropriateness but failed to demonstrate improvements in clinical outcomes. From a health system perspective costs where estimated to increase overall and therefore a different model of medicines management is required.
机译：目标在英国，70%的疗养院居民每天都会经历药物错误，因此建议在医生、药剂师和疗养院之间进行更好的多专业工作。本研究的目的是确定老年人护理院多专业药物评估（MPMR）服务的有效性（减少跌倒）和成本效益。方法在12个月的试验期间，将英格兰东部的所有护理院随机分组，进行“常规护理”或两次多专业（全科医生、临床药剂师和护理院工作人员）药物检查。目标招募人数为900名居民，10%假设后续损失。共同主要结果指标是跌倒次数和通过老年人处方筛查工具评估的潜在不当处方。主要研究结果共招募了826名护理院居民，其中324人因至少一项主要结果指标而失去随访。干预组每位居民每年跌倒的平均次数为3.3次，对照组为3.0次（P=0.947）。研究发现，每位居民在12个月后服用了0.69（干预）和0.85（对照）可能不合适的药物（P=0.046）。在急诊入院或死亡方面没有发现显著差异。干预组每名居民未经调整的估计增量平均成本高出374.26磅。结论与养老院其他基于药物评估的干预措施一样，两个MPMR改善了药物的适宜性，但未能证明临床结果的改善。从卫生系统的角度来看，估计总体成本会增加，因此需要一种不同的药物管理模式。

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