Legris Marie-Ève, Séguin Noémie Charbonneau, Desforges Katherine, Sauvé Patricia, Lord Anne, Bell Robert, Berbiche Djamal, Desrochers Jean-François, Lemieux Jean-Philippe, Morin-Bélanger Claudia, Ste-Marie Paradis François, Lalonde Lyne
Université de Montréal, Hôpital Maisonneuve-Rosemont, Montréal, Canada.
J Contin Educ Health Prof. 2011 Summer;31(3):140-50. doi: 10.1002/chp.20119.
Chronic kidney disease (CKD) patients are multimorbid elderly at high risk of drug-related problems. A Web-based training program was developed based on a list of significant drug-related problems in CKD patients requiring a pharmaceutical intervention. The objectives were to evaluate the impact of the program on community pharmacists' knowledge and skills and their satisfaction with the training.
Pharmacists were randomized to the training program or the control group. Training comprised a 60-minute Web-based interactive session supported by a clinical guide. Pharmacists completed a questionnaire on knowledge (10 multiple-choice questions) and skills (2 clinical vignettes) at baseline and a second time within 1 month. Trained pharmacists completed a written satisfaction questionnaire. Semidirected telephone interviews were conducted with 8 trained pharmacists. Changes in knowledge and skills scores were compared between the groups.
Seventy pharmacists (training: 52; control: 18) were recruited; the majority were women with <15 years' experience. Compared with the control group, an adjusted incremental increase in the knowledge score (22%; 95% confidence interval [CI]: 16%-27%) and skills score (24%; 95% CI: 16%-33%) was observed in the training group. Most pharmacists (87%-100%) rated each aspect of the program "excellent'' or "very good." Additional training and adding a discussion forum were suggested to complement the program.
Pharmacists like the Web-based continuing education program. Over a short time span, the program improved their knowledge and skills. Its impact on their clinical practices and quality of medication use in CKD patients remains to be assessed.
慢性肾脏病（CKD）患者多为多病共存的老年人，存在药物相关问题的高风险。基于一份需要药物干预的CKD患者重大药物相关问题清单，开发了一个基于网络的培训项目。目的是评估该项目对社区药师知识和技能的影响以及他们对培训的满意度。
将药师随机分为培训组或对照组。培训包括一个由临床指南支持的60分钟基于网络的互动课程。药师在基线时以及1个月内再次完成一份关于知识（10道多项选择题）和技能（2个临床案例）的问卷。接受培训的药师完成一份书面满意度问卷。对8名接受培训的药师进行了半定向电话访谈。比较两组知识和技能得分的变化。
招募了70名药师（培训组：52名；对照组：18名）；大多数是经验不足15年的女性。与对照组相比，培训组的知识得分（22%；95%置信区间[CI]：16%-27%）和技能得分（24%；95%CI：16%-33%）有调整后的增量增加。大多数药师（87%-100%）对该项目的各个方面评价为“优秀”或“非常好”。建议增加额外培训并添加一个讨论论坛来完善该项目。
药师喜欢这个基于网络的继续教育项目。在短时间内，该项目提高了他们的知识和技能。其对他们的临床实践以及CKD患者用药质量的影响仍有待评估。
