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评估旅行用药相关风险的药学服务模式。

Pharmaceutical care model to assess the medication-related risks of travel.

作者信息

Heslop Ian M, Bellingan Michelle, Speare Richard, Glass Beverley D

机构信息

Pharmacy (Building 47), College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia,

出版信息

Int J Clin Pharm. 2014 Dec;36(6):1196-204. doi: 10.1007/s11096-014-0016-9. Epub 2014 Oct 1.

Abstract

BACKGROUND

People are at greater risk of health problems when travelling and a significant number of travel-related health problems are associated with the effects of travel on pre-existing chronic diseases. Medications play a key role in the management of these conditions. However, there is a notable lack of research evaluating the potential medication-related risks associated with travel.

OBJECTIVE

To apply a systematic pharmaceutical care model developed to evaluate potential pharmaceutical risks (PPRs) and pharmaceutical care issues (PCIs) in travellers.

SETTING

Adult travellers leaving Cairns International Airport, Australia, for an international destination.

METHOD

A cross-sectional survey using semi-structured interviews, including a systematic medication history, followed by the application of a pharmaceutical care model to evaluate each participant for PPRs and PCIs.

MAIN OUTCOME MEASURE

Evaluation of standard clinical and travel-related PPRs and PCIs.

RESULTS

Medications for chronic diseases were being taken by 47.7% of the 218 travellers interviewed. Although 75.2% of participants presented with no PPRs, a total of 274 PCIs were identified across 61.5% of the participants, with an average of 2.04 PCIs per participant. The most prevalent PCIs related to the inadequate precautions taken by some travellers visiting malaria-endemic regions. Although 91 participants recognised that they were travelling to malaria-endemic regions, 65.9% of these participants were not using malarial chemoprophylaxis, and only 16.5% were using chemoprophylaxis that fully complied with standard recommendations. The second most prevalent PCI was the need for 18.8% of participants to be educated about their medications. Other PCIs identified have the potential to increase the risk of acute, travel-related conditions, and complicate the care of travellers, if they inadvertently became unwell while overseas.

CONCLUSION

PPRs and PCIs were not identified in all participants. However, the impact of many of the identified medication-related issues could be substantial to the traveller. This study represents the novel application of a pharmaceutical care model to identify potential PPRs and PCIs in travellers that may not be identified by other pre-travel risk assessment methods.

摘要

背景

人们在旅行时面临更大的健康问题风险,且大量与旅行相关的健康问题与旅行对既有慢性病的影响有关。药物在这些病症的管理中起着关键作用。然而,明显缺乏评估与旅行相关的潜在药物风险的研究。

目的

应用一种为评估旅行者潜在药物风险(PPRs)和药学服务问题(PCIs)而开发的系统药学服务模式。

地点

从澳大利亚凯恩斯国际机场前往国际目的地的成年旅行者。

方法

采用半结构化访谈进行横断面调查,包括系统的用药史,随后应用药学服务模式评估每位参与者的PPRs和PCIs。

主要观察指标

评估标准临床和与旅行相关的PPRs及PCIs。

结果

在接受访谈的218名旅行者中,47.7%的人正在服用慢性病药物。尽管75.2%的参与者没有PPRs,但在61.5%的参与者中总共识别出274个PCIs,每位参与者平均有2.04个PCIs。最常见的PCIs与一些前往疟疾流行地区的旅行者预防措施不足有关。尽管91名参与者认识到他们前往疟疾流行地区,但这些参与者中有65.9%未使用疟疾化学预防药物,只有16.5%的人使用的化学预防药物完全符合标准建议。第二常见的PCIs是18.8%的参与者需要接受有关其药物的教育。识别出的其他PCIs有可能增加急性旅行相关病症的风险,并且如果旅行者在海外意外生病,会使旅行者的护理变得复杂。

结论

并非所有参与者都识别出PPRs和PCIs。然而,许多已识别出的与药物相关问题对旅行者的影响可能很大。本研究代表了药学服务模式在识别旅行者中潜在PPRs和PCIs方面的新应用,而其他旅行前风险评估方法可能无法识别这些风险。

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