Faculty of Pharmacy, The University of Sydney, Sydney, NSW, Australia.
J Eval Clin Pract. 2011 Feb;17(1):97-103. doi: 10.1111/j.1365-2753.2010.01374.x. Epub 2010 Sep 2.
Drug-related problems (DRPs) in Australian aged care homes have been studied previously. However, little is known about the acceptance and implementation of pharmacists' recommendations by general practitioners (GPs) to resolve DRPs.
The primary objective of this study was to investigate the number and nature of DRPs identified by accredited clinical pharmacists. The secondary objective was to study the GP acceptance and implementation of pharmacist recommendations to resolve DRPs.
This was a retrospective study of 500 randomly selected, de-identified medication reviews performed by 10 accredited clinical pharmacists over 6 months across 62 aged care homes. The DRPs identified by pharmacists were subsequently classified by the drugs involved, types of problem (indication, effectiveness and safety) and medical diagnoses of the patient. GP written feedback on the medication review reports determined implementation of pharmacists' recommendations to resolve the DRPs.
A total of 1433 DRPs were identified in 480 of the 500 residents. Potential DRPs were frequently classified as risk of adverse drug reactions, need for additional monitoring and inappropriate choice of a drug. Alimentary, cardiovascular, central nervous system and respiratory drugs were most frequently implicated, accounting for more than 75% of the DRPs. GPs' acceptance and implementation of pharmacists recommendations were 72.5% (95% CI; 70.2, 74.8) and 58.1% (95% CI; 55.5, 60.6), respectively.
Over 96% of the residents had potential DRPs identified by pharmacists. GP acceptance of pharmacists' recommendations was independent of the drug category, but not independent of the disease category.
先前已经对澳大利亚老年护理院的药物相关问题（DRP）进行了研究。但是，对于药剂师为解决 DRP 而提出的建议被全科医生（GP）接受和执行的情况，人们知之甚少。
本研究的主要目的是调查经认证的临床药剂师确定的 DRP 的数量和性质。次要目的是研究 GP 对解决 DRP 的药剂师建议的接受和执行情况。
这是一项回顾性研究，对 62 家老年护理院的 10 名经认证的临床药剂师在 6 个月内随机选择的 500 份药物评估进行了分析。药剂师确定的 DRP 随后根据涉及的药物、问题类型（适应症、疗效和安全性）和患者的医疗诊断进行分类。根据药物评估报告中 GP 的书面反馈来确定药剂师建议解决 DRP 的实施情况。
在 500 名居民中，有 480 名居民确定了 1433 个 DRP。潜在的 DRP 通常被归类为药物不良反应的风险、需要额外监测和药物选择不当。胃肠道、心血管、中枢神经系统和呼吸系统药物最常涉及，占 DRP 的 75%以上。GP 对药剂师建议的接受和执行率分别为 72.5%（95%CI；70.2，74.8）和 58.1%（95%CI；55.5，60.6）。
超过 96%的居民被药剂师确定存在潜在的 DRP。GP 对药剂师建议的接受情况与药物类别无关，但与疾病类别有关。
