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首页> 外文期刊>Sociology of health & illness >Compliance and concordance during domiciliary medication review involving pharmacists and older people.
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Compliance and concordance during domiciliary medication review involving pharmacists and older people.

机译：涉及药剂师和老年人的住所用药审查过程中的依从性和一致性。

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摘要

Medication review is an advanced service registered pharmacists can now offer patients in the UK. This in-depth study of pharmacist-older patient communication during domiciliary medication review encounters examines how the interactions are constructed by participants and the influence of the compliance paradigm on the interaction. Twenty-nine observed, taped and transcribed consultations were analysed using discourse analysis. Ethnographic-style interviews in the field with pharmacists, follow-up interviews with patients and feedback workshops with pharmacists allowed interpretations to be tested and strengthened. The findings presented here use discourse analysis to look at the task-driven nature of the medication review encounters. The analysis explores the interactional format of three over-lapping phases of the consultations: (i) introductions and agenda setting; (ii) screening and testing patients' ability to comply; and, (iii) investigating over-the-counter medicines. Analysis suggests that a dominant compliance paradigm encourages pharmacist-led encounters with patients failing to engage in the medication review process. Little evidence of two-way reciprocated discussion or concordance was evident. The strategic nature of the discourse of compliance heard in these medication review encounters and its effect on older patients are discussed. The paper concludes with a consideration of the implications for pharmacy practice and policy development.
机译：药物审查是一项高级服务，注册药剂师现在可以为英国的患者提供服务。这项在住所用药审查期间对药剂师与长者患者沟通的深入研究探讨了参与者如何构建交互作用以及依从性范式对交互作用的影响。使用话语分析法分析了29个观察，录音和转录的咨询。在该领域与药剂师进行的民族志式访谈，对患者的后续访谈以及与药剂师的反馈研讨会，可以检验和加强解释。此处呈现的发现使用话语分析来查看药物审查遇到的任务驱动性质。分析探讨了磋商的三个重叠阶段的互动形式：（i）引言和议程制定; （ii）筛选和测试患者的依从能力; （iii）调查非处方药。分析表明，主要的依从性范式鼓励药剂师主导的与未能参与药物审查过程的患者的相遇。很少有双向互动讨论或协调的证据。讨论了在这些用药复习中听到的依从性话语的战略性质及其对年长患者的影响。本文最后考虑了对药学实践和政策制定的影响。

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