Curtin Health and Innovation Research Institute, School of Pharmacy, Curtin University, GPO Box U1987, Perth, WA, Australia, 6845.
BMC Geriatr. 2012 Jul 11;12:25. doi: 10.1186/1471-2318-12-25.
Current model of medication supply to Residential Aged Care Facilities (RACFs) in Australia is dependent on paper-based prescriptions. This study is aimed at assessing the use of a centralized medication chart as a prescription-less model for supplying medications to RACFs.
Two separate focus groups were conducted with general practitioners (GPs) and pharmacists, and another three with registered nurses (RNs) and carers combined. All focus group participants were working with RACFs. Audio-recorded data were compared with field notes, transcribed and imported into NVivo® where it was thematically analyzed.
A prescription-less medication chart model was supported and it appeared to potentially improve medication supply to RACF residents. Centralization of medication supply, clarification of medication orders and responding in real-time to therapy changes made by GPs were reasons for supporting the medication chart model. Pharmacists preferred an electronic version of this model. All health professionals cautioned against the need for GPs regularly reviewing the medication chart and proposed a time interval of four to six months for this review to occur. Therapy changes during weekends appeared a potential difficulty for RNs and carers whereas pharmacists cautioned about legible writing and claiming of medications dispensed according to a paper-based model. GPs cautioned on the need to monitor the amount of medications dispensed by the pharmacy.
The current use of paper prescriptions in nursing homes was identified as burdensome. A prescription-less medication chart model was suggested to potentially improve medication supply to RACF residents. An electronic version of this model could address main potential difficulties raised.
澳大利亚养老院（RACF）的药物供应目前依赖于纸质处方。本研究旨在评估集中式用药图表作为向 RACF 提供药物的无处方模式的使用情况。
分别对全科医生（GP）和药剂师进行了两次焦点小组讨论，对注册护士（RN）和护理人员进行了另外三次焦点小组讨论。所有参与焦点小组的人员都与 RACF 合作。将录音数据与现场记录进行比较、转录并导入 NVivo®，然后对其进行主题分析。
支持无处方用药图表模型，该模型似乎有可能改善 RACF 居民的药物供应。药物供应的集中化、药物医嘱的澄清以及对 GP 治疗变化的实时响应是支持用药图表模型的原因。药剂师更喜欢这种模型的电子版。所有医疗保健专业人员都警告说，GP 需要定期审查用药图表，并建议每四到六个月进行一次审查。RN 和护理人员在周末期间的治疗变化似乎是一个潜在的困难，而药剂师则警告说，根据纸质模型，书写清晰和要求配药是困难的。GP 警告说需要监测药房配发的药物数量。
研究确定养老院目前使用纸质处方是繁琐的。建议使用无处方用药图表模型，以潜在改善 RACF 居民的药物供应。该模型的电子版可以解决主要提出的潜在困难。
