Lee Jeannie K, Grace Karen A, Taylor Allen J
College of Pharmacy, University of Arizona, Tucson, AZ, USA;
Patient Prefer Adherence. 2009 Nov 3;3:93-8. doi: 10.2147/ppa.s5394.
Clinical practice research provides a unique opportunity to care for a diverse patient population in various health care system settings. Federal study of Adherence to Medications in the Elderly (FAME) was the first prospective observational and randomized controlled trial to implement effective strategies to enhance medication adherence and health outcomes in older patients using polypharmacy. Ten lessons learned from conducting this adherence intervention trial are described: (1) Link the trial to existing clinical work, (2) Begin with a thorough understanding of medication adherence, (3) Ensure that trial highlights individualized intervention, (4) Tailor inclusion criteria and study duration to target population, (5) Employ a range of outcomes linked to meaningful clinical effects, (6) Win the support of the multidisciplinary team and the administration, (7) Promote team work, (8) Consider the potential limitations, (9) Seize the grant opportunities, and (10) Share the findings.
临床实践研究为在各种医疗保健系统环境中照顾不同的患者群体提供了独特的机会。老年人药物依从性联邦研究(FAME)是首个前瞻性观察性和随机对照试验,旨在实施有效策略以提高使用多种药物治疗的老年患者的药物依从性和健康结局。本文描述了从开展这项依从性干预试验中学到的十条经验教训:(1)将试验与现有的临床工作联系起来;(2)从全面了解药物依从性开始;(3)确保试验突出个性化干预;(4)根据目标人群调整纳入标准和研究持续时间;(5)采用一系列与有意义的临床效果相关的结局指标;(6)赢得多学科团队和管理层的支持;(7)促进团队合作;(8)考虑潜在的局限性;(9)抓住资助机会;(10)分享研究结果。