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药物评估项目:为患有慢性病且服用多种药物的人群提供全面的药物评估。

The Medication Assessment Program: comprehensive medication assessments for persons taking multiple medications for chronic diseases.

作者信息

Lewis Nancy J W, Bugdalski-Stutrud Carol, Abate Marie A, Blommel Matthew, Wu Chung-Hsuen, Gaither Caroline A

机构信息

Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit; Center for Medication Use, Policy & Economics, College of Pharmacy, University of Michigan, Ann Arbor..

Community Experiential Education Programs, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit.

出版信息

J Am Pharm Assoc (2003). 2008 Mar-Apr;48(2):171-180. doi: 10.1331/JAPhA.2008.07141.

Abstract

OBJECTIVE

To describe the development, implementation, and evaluation of a pharmacist patient care program for persons taking multiple medications for chronic diseases.

DESIGN

Pilot study.

SETTING

Services were provided in Michigan within community pharmacies and through home and work-site visits, between October 2004 and September 2006.

PARTICIPANTS

30 pharmacists and 67 patients 18 years of age or older who took four or more medications on a routine basis (three or more times per week).

INTERVENTIONS

The comprehensive medication assessments identified medication- and health-related problems. Pharmacists provided patient education supported by written educational materials and written recommendations for improving drug therapy and overall patient health.

MAIN OUTCOME MEASURES

Patient knowledge regarding medications, diagnoses, and healthy lifestyle practices; types of recommendations made; recommendation acceptance rates; pharmacist assessment of program effects.

RESULTS

The program was developed and implemented through a collaborative approach that included pharmacists, colleges of pharmacy, and employers. Pharmacists were supported by various administrative and clinical services offered by the colleges. Three employers adopted the program as a service for their employees, retirees, and dependents. A total of 67 patients received comprehensive medication assessments. Patients tended to be women, tended to be older, and took an average of 12.6 medications. Pharmacists provided 662 recommendations related to drug therapy, healthy lifestyle practices, and the need for medical evaluation. Recommendation acceptance rates, changes in patient knowledge, and pharmacist evaluation of program effects indicated that the program had a positive effect on patient health.

CONCLUSION

A collaborative approach to developing and implementing comprehensive medication assessments was found to be beneficial in improving patient understanding of medications, diagnoses, and healthy lifestyle choices. Written pharmacist recommendations resulted in actions that improved self-monitoring skills and drug therapy appropriateness. College of pharmacy administrative and clinical service support was instrumental in network participation and the provision of care.

摘要

目的

描述一项针对服用多种慢性病药物患者的药师患者护理项目的开发、实施及评估情况。

设计

试点研究。

地点

2004年10月至2006年9月期间,在密歇根州的社区药房以及通过上门和工作场所探访提供服务。

参与者

30名药师和67名18岁及以上的患者,这些患者常规服用四种或更多药物(每周三次或更多次)。

干预措施

全面的药物评估识别出与药物和健康相关的问题。药师提供患者教育,并辅以书面教育材料以及关于改善药物治疗和整体患者健康的书面建议。

主要观察指标

患者对药物、诊断和健康生活方式的了解;所提建议的类型;建议接受率;药师对项目效果的评估。

结果

该项目通过包括药师、药学院和雇主在内的协作方式开发和实施。药师得到了药学院提供的各种行政和临床服务的支持。三家雇主采用该项目为其员工、退休人员和家属提供服务。共有67名患者接受了全面的药物评估。患者多为女性,年龄较大,平均服用12.6种药物。药师提供了662条与药物治疗、健康生活方式以及医疗评估需求相关的建议。建议接受率、患者知识的变化以及药师对项目效果的评估表明,该项目对患者健康有积极影响。

结论

发现采用协作方式开发和实施全面的药物评估有助于提高患者对药物、诊断和健康生活方式选择的理解。药师的书面建议促成了有助于提高自我监测技能和药物治疗合理性的行动。药学院的行政和临床服务支持对网络参与和护理提供起到了重要作用。

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