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药剂师教育对模拟患者哮喘治疗方案的影响。

The effect of pharmacist education on asthma treatment plans for simulated patients.

作者信息

Dolovich Lisa, Sabharwal Mona, Agro Karen, Foster Gary, Lee Annie, McCarthy Lisa, Willan Andrew R

机构信息

Centre for Evaluation of Medicines, St. Joseph's Healthcare, L8N 1G6, Hamilton, ON, Canada.

出版信息

Pharm World Sci. 2007 Jun;29(3):228-39. doi: 10.1007/s11096-006-9080-0. Epub 2007 Jan 23.

Abstract

OBJECTIVE

To determine if an educational program designed for community pharmacists to help patients self manage their asthma could improve pharmacists abilities to facilitate asthma treatment plans. Setting Hamilton and Toronto, Ontario, Canada.

METHOD

A randomized controlled trial involving volunteer community pharmacists who received either an asthma education program (AEP; intervention group) or a delayed AEP (control group). The AEP consisted of a one-day workshop and two follow-up telephone calls. Teaching methods progressed from a didactic approach to self-directed learning and role playing with simulated patients (SPs). The primary outcome was measured by SPs who conducted unannounced pharmacy visits.

MAIN OUTCOMES MEASURES

The number of appropriate (defined a priori) action plans facilitated by the pharmacist was the primary outcome. Facilitated was defined as the pharmacist recommending a specific plan, taking responsibility for telephoning the physician, or ensuring the patient would take responsibility for contacting the physician.

RESULTS

Thirty-three pharmacists were randomized to the intervention group and 31 pharmacists were randomized to the control group. Pharmacists in the intervention group facilitated an appropriate plan in 44.8% of situations (117 out of a possible 261) compared with 29.3% (79 out of a possible 270) in the control group, (mean difference 15.5% (95% CI: 7.4-23.8%; P = 0.0004)). Intervention group pharmacists were better able to facilitate plans for the 'under use of inhaled corticosteroids,' 'exposure to pet dander as an asthma trigger,' and 'overuse of short-acting beta-agonist' problems. Intervention group pharmacists exhibited better overall communication skills (including empathy, coherence, verbal skills, and nonverbal skills).

CONCLUSION

This AEP produced improvements in pharmacists' abilities to facilitate plans for SPs in a community pharmacy setting.

摘要

目的

确定一项为社区药剂师设计的、帮助患者自我管理哮喘的教育项目是否能提高药剂师推动哮喘治疗计划实施的能力。研究地点为加拿大安大略省的汉密尔顿和多伦多。

方法

一项随机对照试验,涉及志愿参与的社区药剂师,他们被分为接受哮喘教育项目(AEP;干预组)或延迟接受AEP(对照组)。AEP包括为期一天的研讨会和两次随访电话。教学方法从讲授式逐步转变为自主学习以及与模拟患者(SPs)进行角色扮演。主要结果由进行不预先通知的药房访视的SPs进行衡量。

主要结局指标

药剂师推动制定的合适(预先定义)行动计划的数量为主要结局。推动制定被定义为药剂师推荐具体计划、负责致电医生或确保患者负责联系医生。

结果

33名药剂师被随机分配到干预组,31名药剂师被随机分配到对照组。干预组的药剂师在44.8%的情况下(在可能的261例中为117例)推动制定了合适的计划,而对照组为29.3%(在可能的270例中为79例),(平均差异15.5%(95%CI:7.4 - 23.8%;P = 0.0004))。干预组的药剂师在促进“吸入性糖皮质激素使用不足”、“接触宠物皮屑作为哮喘触发因素”以及“短效β受体激动剂过度使用”问题的计划制定方面表现更佳。干预组的药剂师展现出更好的整体沟通技巧(包括同理心、连贯性、语言技巧和非语言技巧)。

结论

该哮喘教育项目提高了药剂师在社区药房环境中为模拟患者推动计划实施的能力。

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