Montgomery A T, Sporrong S Kälvemark, Tully M P, Lindblad A Kettis
Department of Pharmacy, Uppsala University, Uppsala, Sweden.
J Clin Pharm Ther. 2008 Dec;33(6):653-62. doi: 10.1111/j.1365-2710.2008.00965.x.
Pharmaceutical care (PC) services are increasingly provided in community pharmacies in the western world. Evaluations are often conducted as trials in highly controlled conditions measuring the efficacy of the service in terms of the economical, clinical and humanistic outcomes. Little is known about the real world provision of PC services and the factors associated with follow-up.
To characterize patients receiving a PC service, to explore factors associated with follow-up evaluations, and to describe the results of pharmacists' interventions.
A non-experimental, retrospective study using the Swedish national patient medication records data base. Patients receiving follow-up evaluations or one consultation within the service were compared using logistic regression.
A total of 3298 patients received the PC service at 240 community pharmacies. Patient characteristics included: 66.3% female, mean age 71.1 years, mean number of prescription drugs used 10.5, with 86.2% of patients using >or=1 cardiovascular drugs. A quarter (25.8%) of patients had >or=1 drug-related problems, most commonly side effects. Follow-up evaluations were carried out for 46.6% of the patients, who were more likely to use a compliance aid. Patients receiving the PC service at pharmacies that had enrolled more than the mean number of patients (13.7) had twice as high a chance of receiving follow-up than those registered with pharmacies with fewer patients (i.e. below the mean) enrolled. Followed-up interventions led to a better perceived outcome in 46.3% of cases, no change in 48.5% and a worse outcome in 5.2%.
This study demonstrates that the total number of patients enrolled in a PC service predicts whether follow-up evaluations will take place or not more than do patient characteristics.
在西方世界，社区药房越来越多地提供药学服务（PC）。评估通常在高度受控的条件下作为试验进行，从经济、临床和人文结果方面衡量该服务的效果。对于PC服务在现实世界中的提供情况以及与随访相关的因素知之甚少。
描述接受PC服务的患者特征，探索与随访评估相关的因素，并描述药剂师干预的结果。
一项使用瑞典国家患者用药记录数据库的非实验性回顾性研究。使用逻辑回归比较在该服务中接受随访评估或一次咨询的患者。
共有3298名患者在240家社区药房接受了PC服务。患者特征包括：66.3%为女性，平均年龄71.1岁，平均使用处方药数量为10.5种，86.2%的患者使用≥1种心血管药物。四分之一（25.8%）的患者有≥1个药物相关问题，最常见的是副作用。46.6%的患者接受了随访评估，这些患者更有可能使用依从性辅助工具。在登记患者数量超过平均数量（13.7）的药房接受PC服务的患者接受随访的机会是登记患者数量较少（即低于平均水平）的药房患者的两倍。随访干预在46.3%的病例中导致更好的感知结果，48.5%无变化，5.2%结果更差。
本研究表明，参与PC服务的患者总数比患者特征更能预测是否会进行随访评估。
