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教育会议和小组详细讲解会改变医院对药物处方集的依从性吗?一项整群随机对照试验。

Do educational meetings and group detailing change adherence to drug formularies in hospitals? A cluster randomized controlled trial.

作者信息

Plet Hanne T, Kjeldsen Lene J, Christensen René de Pont, Nielsen Gitte S, Hallas Jesper

出版信息

Eur J Clin Pharmacol. 2014 Jan;70(1):109-16. doi: 10.1007/s00228-013-1589-2.

DOI:10.1007/s00228-013-1589-2
PMID:24077960
Abstract

PURPOSE

The aim of this study was to examine whether educational meetings and group detailing could increase the use of drugs from the ward lists or the drug formulary in hospitals.

METHODS

Twelve medical wards from two hospitals were randomized into three groups: control, basic and extended intervention. All wards had a ward list review before interventions. Moreover, the basic intervention consisted of an educational meeting, and the extended intervention included two group detailing sessions. The proportion of drugs used from the ward list or hospital drug formulary (HDF) was the primary outcome. Data (defined daily doses [DDDs], numbers and cost [Euros]) on drugs sold to the wards were retrieved from the two hospitals from 1 July 2011 to 31 August 2012.

BASELINE DATA

from July to September 2011, and follow-up data: from June to August 2012.

RESULTS

The proportion of formulary drugs used increased for the extended intervention group (0.04, range -0.02 to 0.09) and basic intervention group (0.03, range -0.03 to 0.09) in comparison with a decrease in the control group (-0.01, range -0.03 to -0.02). The interventions did not significantly change odds for selecting drugs from the formulary in comparison with the control group (basic intervention: OR 1.09 [95 % CI 0.81 to 1.46]; extended intervention: OR 1.00 [95 % CI 0.75 to 1.35]).

CONCLUSIONS

In this study, educational meetings and group detailing do not significantly improve adherence to ward lists or HDF. The adherence to the formularies at baseline was relatively high, which may explain why the interventions did not have a significant effect.

摘要

目的

本研究旨在探讨教育会议和小组详细讲解是否能增加医院病房清单或药品处方集上药物的使用。

方法

将两家医院的12个内科病房随机分为三组:对照组、基础干预组和强化干预组。所有病房在干预前均进行了病房清单审查。此外,基础干预包括一次教育会议,强化干预包括两次小组详细讲解。使用病房清单或医院药品处方集(HDF)上药物的比例是主要结果。从2011年7月1日至2012年8月31日从两家医院获取出售给病房的药物数据(限定日剂量[DDD]、数量和成本[欧元])。

基线数据

2011年7月至9月,随访数据:2012年6月至8月。

结果

与对照组下降(-0.01,范围-0.03至-0.02)相比,强化干预组(0.04,范围-0.02至0.09)和基础干预组(0.03,范围-0.03至0.09)使用处方集药物的比例有所增加。与对照组相比,干预措施并未显著改变从处方集中选择药物的几率(基础干预:OR 1.09 [95% CI 0.81至1.46];强化干预:OR 1.00 [95% CI 0.75至1.35])。

结论

在本研究中,教育会议和小组详细讲解并未显著提高对病房清单或HDF的依从性。基线时对处方集的依从性相对较高,这可能解释了为何干预措施未产生显著效果。

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