St Paul's Hospital, Chronic Kidney Disease Clinic, 1702-20th St W, Saskatoon, SK S7M 0Z9.
Can Fam Physician. 2009 Dec;55(12):e86-91.
To determine if there is improvement in medication management when pharmacists and family physicians collaborate to prescribe medication renewals requested by fax.
Prospective, non-randomized controlled trial.
W est Winds Primary Health Centre, an interdisciplinary health centre that includes an academic family medicine practice, located in Saskatoon, Sask.
All patients whose pharmacies faxed the health centre requesting prescription renewals between October 2007 and February 2008 were selected to participate in the study.
Medication renewal requests were forwarded to the pharmacist (who works in the clinic part-time) on days when he was working (intervention group). The pharmacist assessed drug-therapy issues that might preclude safe and effective prescribing of the medication. The pharmacist and physician then made a collaborative decision to authorize the requested medication or to request additional interventions first (eg, perform laboratory tests). When the pharmacist was not working, the physicians managed the renewal requests independently (control group).
Medication renewals authorized with no recommendations, medication-related problems identified, new monitoring tests ordered, and new appointments scheduled with health providers.
A total of 181 renewal requests were included (94 in the control group and 87 in the intervention group). The control group had significantly more requests authorized with no recommendations (75.5% vs 52.9%, P = .001). Those in the intervention group had significantly more medication-related problems identified (26 vs 10, P = .031); medication changes made (24 vs 10, P = .044); and new appointments scheduled with their family physicians (31 vs 21, P = .049).
There is an improvement in medication management when a pharmacist collaborates with family physicians to prescribe medication renewals. The collaborative model created significantly more activity with each renewal request (ie, identification of medication-related problems, medication changes, and new appointments), which reflects an improvement in the process of care.
确定药剂师与家庭医生合作通过传真开具药物续方时，药物管理是否得到改善。
前瞻性、非随机对照试验。
西风水岸初级保健中心，萨斯卡通市的一个跨学科健康中心，其中包括一个学术性家庭医学实践。
所有药房通过传真向健康中心要求续方的患者都被选中参加研究，选择时间为 2007 年 10 月至 2008 年 2 月期间。
在药剂师（兼职在诊所工作）上班的日子，药物续方请求被转发给药剂师（干预组）。药剂师评估可能导致药物治疗不安全和无效的药物治疗问题。然后，药剂师和医生共同决定授权要求的药物续方，或者首先要求采取其他干预措施（例如，进行实验室检查）。当药剂师不上班时，医生独立管理续方请求（对照组）。
无建议授权的药物续方、确定药物相关问题、新监测测试订单和与卫生提供者预约新的就诊。
共纳入 181 例续方请求（对照组 94 例，干预组 87 例）。对照组无建议授权的续方请求明显更多（75.5%比 52.9%，P =.001）。干预组确定的药物相关问题明显更多（26 比 10，P =.031）；进行药物更改的明显更多（24 比 10，P =.044）；并与家庭医生预约新的就诊的明显更多（31 比 21，P =.049）。
当药剂师与家庭医生合作开具药物续方时，药物管理得到改善。协作模式使每个续方请求的活动量显著增加（即，确定药物相关问题、药物更改和新的预约），这反映了护理过程的改善。
