Langford Bradley J, Jorgenson Derek, Kwan Debora, Papoushek Christine
Department of Pharmacy, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
Pharmacotherapy. 2006 Feb;26(2):260-8. doi: 10.1592/phco.26.2.260.
To determine if a self-administered questionnaire can improve the identification of patients at risk for medication-related problems (MRPs) compared with usual methods of referral to a pharmacist.
Prospective, randomized controlled study.
Multiprofessional primary care clinic at a tertiary care teaching hospital.
One hundred ninety-four ambulatory patients aged 18 years or older who were taking at least two drugs.
Patients completed a five-item, self-administered questionnaire modified from a tool that was previously validated in another population and statistically correlated with the risk of MRPs. Of 194 patients who completed the questionnaire, 89 were randomized to the control group (referral by usual methods) and 105 were referred according to their responses on the questionnaire (intervention group). Primary outcomes were the rate of referral and the number of at-risk patients identified. Referral rates were higher with the questionnaire than with usual methods (20% vs 6%, p=0.003). Of five patients referred by usual methods, one was at risk for MRPs according to questionnaire results. Of 84 patients in the control group who were not referred, 12 (14%) were at risk according to the questionnaire results; this finding suggested that several at-risk patients who were not referred by usual methods might have benefitted from a referral for a pharmacist's assessment.
This self-administered medication risk assessment questionnaire effectively complemented the usual practices for identifying and referring patients at risk for MRPs.
与常规的药师转诊方法相比,确定一份自我管理问卷能否改善对有用药相关问题(MRP)风险患者的识别。
前瞻性随机对照研究。
一所三级护理教学医院的多专业初级保健诊所。
194名18岁及以上的门诊患者,他们正在服用至少两种药物。
患者完成了一份五项自我管理问卷,该问卷改编自先前在另一人群中验证过且与MRP风险具有统计学相关性的工具。在完成问卷的194名患者中,89名被随机分配到对照组(常规方法转诊),105名根据问卷回答被转诊(干预组)。主要结局是转诊率和识别出的有风险患者数量。问卷转诊率高于常规方法(20%对6%,p = 0.003)。在通过常规方法转诊的5名患者中,根据问卷结果有1名有MRP风险。在未被转诊的对照组84名患者中,根据问卷结果有12名(14%)有风险;这一发现表明,一些未通过常规方法转诊的有风险患者可能会从药师评估转诊中受益。
这份自我管理的用药风险评估问卷有效地补充了识别和转诊有MRP风险患者的常规做法。