Roughead Elizabeth, Pratt Nicole, Peck Robert, Gilbert Andrew
Quality Use of Medicines and Pharmacy Research Centre; Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA 5001, Australia.
Pharmacoepidemiol Drug Saf. 2007 Jul;16(7):797-803. doi: 10.1002/pds.1393.
To determine if patient-specific prescriber feedback for general medical practitioners (GPs), supported by educational material mailed to their patients, would increase home medicines review (HMR) rates.
An observational study was conducted using the Repatriation Pharmaceutical Benefits Scheme (RPBS) Pharmacy Claims Database. The intervention group (n = 40 270) included all veterans aged >/=65 years, dispensed >/=5 unique medicines each month over a 4 month period. Comparison group veterans (n = 49,227) were those who did not have >/=5 or more unique medicines dispensed each month, but did have at least one prescription each month and >/=20 prescriptions over 4 months, of which five were unique medicines, Intervention GPs (n = 11,384) were subdivided into 2 groups: GPs with intervention veterans (n = 2097) and GPs with both intervention and comparison group veterans (n = 9287). The comparison group of GPs (n = 3630) were primary prescribers to the comparison veterans only. Rates of HMRs pre and post-intervention and the number of new GPs participating in HMR services were examined.
There was a significant increase in HMR rates in intervention group, from 2.2 per 1000 in the pre-period to 4.6 per 1000 per month in the post-intervention period (Rate Ratio (RR) 2.06, 95% Confidence Interval (CI) (1.90, 2.22), p < 0.0001). HMR rates increased in the intervention group compared with the comparison group (p < 0.0001). HMR rates increased in the intervention group GPs compared with the comparison group (RR 1.79, 95% CI (1.58, 2.02), p < 0.0001).
Patient-specific feedback provided to GPs, supported by educational material mailed directly to their patients increased HMR rates for targeted veterans and increased GP participation in the delivery of HMRs.
确定向全科医生（GP）提供针对患者的处方者反馈，并辅以邮寄给患者的教育材料，是否会提高家庭药物审查（HMR）率。
使用退伍军人药品福利计划（RPBS）药房索赔数据库进行了一项观察性研究。干预组（n = 40270）包括所有年龄≥65岁的退伍军人，在4个月期间每月配发≥5种不同药物。对照组退伍军人（n = 49227）是那些每月未配发≥5种或更多不同药物，但每月至少有一张处方且在4个月内有≥20张处方（其中5种为不同药物）的退伍军人。干预组全科医生（n = 11384）分为两组：有干预组退伍军人的全科医生（n = 2097）和既有干预组又有对照组退伍军人的全科医生（n = 9287）。对照组全科医生（n = 3630）仅为对照组退伍军人的主要开方者。研究了干预前后的HMR率以及参与HMR服务的新全科医生数量。
干预组的HMR率显著增加，从干预前的每1000人2.2例增加到干预后时期的每月每1000人4.6例（率比（RR）2.06，95%置信区间（CI）（1.90，2.22），p < 0.0001）。与对照组相比，干预组的HMR率有所增加（p < 0.0001）。与对照组相比，干预组全科医生的HMR率有所增加（RR 1.79，95% CI（1.58，2.02），p < 0.0001）。
向全科医生提供针对患者的反馈，并辅以直接邮寄给患者的教育材料，提高了目标退伍军人的HMR率，并增加了全科医生参与HMR服务的程度。
