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为老年人开展基于社区的、由药剂师提供的跌倒预防药物治疗管理干预:关系建立、方法及原理

The Development of a Community-Based, Pharmacist-Provided Falls Prevention MTM Intervention for Older Adults: Relationship Building, Methods, and Rationale.

作者信息

Mott David A, Martin Beth, Breslow Robert, Michaels Barb, Kirchner Jeff, Mahoney Jane, Margolis Amanda

机构信息

Hammel-Sanders Professor, Social and Administrative Sciences Division, University of Wisconsin-Madison, School of Pharmacy, 777 Highland Avenue, Madison, WI 53705, Office: 608-265-9268 FAX: 608-262-5262.

Associate Professor, Pharmacy Practice Division, University of Wisconsin-Madison, School of Pharmacy.

出版信息

Innov Pharm. 2014;5(1):140. doi: 10.24926/iip.v5i1.322.

Abstract

The objectives of this article are to discuss the process of community engagement experienced to plan and implement a pilot study of a pharmacist-provided MTM intervention focused on reducing the use of medications associated with falling, and to present the research methods that emerged from the community engagement process to evaluate the feasibility, acceptance, and preliminary impact of the intervention. Key lessons learned from the community engagement process also are presented and discussed. The relationship building and planning process took twelve months. The RE-AIM framework broadly guided the planning process since an overarching goal for the community partners was developing a program that could be implemented and sustained in the future. The planning phase focused on identifying research questions that were of most interest to the community partners, the population to study, the capacity of partners to perform activities, process evaluation. Much of the planning phase was accomplished with face-to-face meetings. After all study processes, study materials, and data collection tools were developed, a focus group of older adults who represented the likely targets of the MTM intervention provided feedback related to the concept and process of the intervention. Nine key lessons were identified from the community engagement process. One key to successful community engagement is partners taking the time to educate each other about experiences, processes, and success and failures. Additionally, partners must actively listen to each other to better understand barriers and facilitators that likely will impact the planning and implementation process. Successful community engagement will be important to develop both formative and summative evaluation processes that will help to produce valid evidence about the effectiveness of pharmacists in modifying drug therapy and preventing falls as well as promote adoption and implementation of the intervention in other communities.

摘要

本文的目的是讨论在计划和实施一项由药剂师提供的以减少与跌倒相关药物使用为重点的药物治疗管理(MTM)干预试点研究过程中所经历的社区参与过程,并介绍从社区参与过程中产生的用于评估该干预措施的可行性、可接受性和初步影响的研究方法。还将介绍和讨论从社区参与过程中学到的关键经验教训。建立关系和规划过程耗时十二个月。由于社区合作伙伴的总体目标是制定一个未来可以实施和持续的项目,因此RE-AIM框架广泛指导了规划过程。规划阶段的重点是确定社区合作伙伴最感兴趣的研究问题、要研究的人群、合作伙伴开展活动的能力、过程评估。规划阶段的大部分工作是通过面对面会议完成的。在开发了所有研究流程、研究材料和数据收集工具之后,一个由代表MTM干预可能目标人群的老年人组成的焦点小组提供了与干预概念和过程相关的反馈。从社区参与过程中确定了九个关键经验教训。成功进行社区参与的一个关键是合作伙伴花时间相互了解彼此的经验、过程以及成功与失败。此外,合作伙伴必须积极倾听对方意见,以更好地理解可能影响规划和实施过程的障碍和促进因素。成功的社区参与对于制定形成性和总结性评估过程非常重要,这将有助于产生关于药剂师在改变药物治疗和预防跌倒方面有效性的有效证据,并促进该干预措施在其他社区的采用和实施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc0d/4190035/0b0ce360814f/nihms627896f1.jpg

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