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非临床医生在社区药店管理变应性鼻炎的目标设定模型中的作用。

The role of non-clinicians in a goal setting model for the management of allergic rhinitis in community pharmacy settings.

机构信息

Faculty of Pharmacy, The University of Sydney, Sydney, NSW 2006 Australia.

出版信息

Patient Educ Couns. 2011 Nov;85(2):e26-32. doi: 10.1016/j.pec.2010.10.003. Epub 2010 Nov 2.

Abstract

OBJECTIVE

To test the relative effects of a clinician versus non-clinician delivered goal setting intervention to assist patients presenting with Intermittent Allergic Rhinitis (IAR) in community pharmacies.

METHODS

A 10-day mixed-method, parallel group repeated measures study was conducted in Sydney. Clinicians (pharmacists) and non-clinicians (pharmacy assistants) recruited patients suffering IAR. Intervention group pharmacy staff delivered a brief structured goal setting intervention to support IAR patient self-management whilst the control group delivered standard care.

RESULTS

One hundred and fifty participants (N=77 intervention; N=73 control) were recruited at 20 community pharmacies. Both groups significantly improved on all outcome measures when assisted by either clinicians or non-clinicians. The intervention group patients supported by non-clinicians made significant improvements in self-efficacy and quality of life compared to the control group supported by non-clinicians. Strategies devised to control IAR triggers reflected practical actions whereas adherence and dose information strategies addressed IAR symptoms. Adherence did not impact significantly on self-reported symptom severity.

CONCLUSION

Both clinicians and non-clinicians can deliver this service. There is a need for a detailed and practical approach to assist patients towards a goal-directed and autonomous management of IAR.

PRACTICE IMPLICATIONS

With training non-clinicians can support patients with IAR, reducing the time constraints and workload for clinicians.

摘要

目的

测试临床医生与非临床医生实施目标设定干预以协助社区药房中出现间歇性过敏性鼻炎(IAR)的患者的相对效果。

方法

在悉尼进行了一项为期 10 天的混合方法、平行组重复测量研究。临床医生(药剂师)和非临床医生(药房助理)招募患有 IAR 的患者。干预组药房工作人员提供了简短的结构化目标设定干预,以支持 IAR 患者的自我管理,而对照组则提供标准护理。

结果

在 20 家社区药房共招募了 150 名参与者(N=77 干预组;N=73 对照组)。当由临床医生或非临床医生协助时,两组在所有结局测量上均显著改善。与对照组非临床医生支持的患者相比,由非临床医生支持的干预组患者在自我效能和生活质量方面有显著改善。为控制 IAR 触发因素而制定的策略反映了实际行动,而坚持用药和剂量信息策略则针对 IAR 症状。坚持用药并未对自我报告的症状严重程度产生显著影响。

结论

临床医生和非临床医生都可以提供这项服务。需要采用详细而实用的方法来协助患者实现针对 IAR 的目标导向和自主管理。

实践意义

通过培训,非临床医生可以为 IAR 患者提供支持,减轻临床医生的时间限制和工作负荷。

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