Kaae Susanne, Dam Pernille, Rossing Charlotte
Section for Social and Clinical Pharmacy, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, 2100 København Ø, Denmark.
Department of Research & Development, The Danish College of Pharmacy Practice (Pharmakon), Milnersvej 42, 3400 Hillerød, Denmark.
Res Social Adm Pharm. 2016 May-Jun;12(3):486-95. doi: 10.1016/j.sapharm.2015.08.002. Epub 2015 Aug 12.
Getting a good start in taking new medications for a chronic disease constitutes a crucial step in the establishment of continuous medical treatment. Patients in this phase report problems such as concerns about their new medication, side effects and practical problems, all contributing to the risk of non-adherence. Counseling at the pharmacy counter may not be structured appropriately to address issues of potential non-adherence to new medication. For these reasons, a new pharmacy service in Denmark was developed. The service consists of a 15-min face-to-face interview and a 10-min telephone follow-up interview.
The aim of study was to evaluate the new service with regard to overall patient satisfaction, knowledge, practical problems, a feeling of safety, adherence and concordance.
Questionnaires were constructed using validated scales for adherence and concordance. Further, semi-structured interviews were carried out with a subset of patients to explore their experiences in more depth. Questionnaires were analyzed using IBM SPSS Statistics 19, and interviews were analyzed using meaning condensation.
Patients reported improved knowledge, feelings of safety and a good start in taking the new medication due to the pharmacy service. The majority of patients reported being adherent, but a potential risk of non-adherence was identified in nearly 50% of patients. Only slight improvements in perceived concordance were reported. The positive outcome of the service was mainly due to the first interview. Some patients had concerns about their new situation, which they thought more important to resolve than issues of potential non-adherence.
Patients were satisfied with the pharmacy service and reported that staff helped them get a good start with the new medication. Challenges were observed regarding the follow-up interview. Some patients will also benefit from services more oriented toward resolving their specific medical concerns.
对于慢性病患者而言，开始正确服用新药是建立持续治疗的关键一步。处于这一阶段的患者会报告一些问题，比如对新药的担忧、副作用以及实际问题，这些都会增加不依从治疗的风险。药房柜台的咨询可能没有得到适当的组织，无法解决潜在的不依从新药治疗的问题。基于这些原因，丹麦开展了一项新的药房服务。该服务包括一次15分钟的面对面访谈和一次10分钟的电话随访访谈。
本研究旨在评估这项新服务在患者总体满意度、知识、实际问题、安全感、依从性和一致性方面的效果。
使用经过验证的依从性和一致性量表构建问卷。此外，还对一部分患者进行了半结构化访谈，以更深入地探索他们的经历。使用IBM SPSS Statistics 19对问卷进行分析，使用意义浓缩法对访谈进行分析。
患者报告称，由于药房服务，他们对新药的了解有所增加，安全感增强，并且在开始服用新药方面有了良好的开端。大多数患者报告称能够坚持服药，但近50%的患者被发现存在潜在的不依从风险。在感知一致性方面仅有轻微改善。该服务的积极结果主要归功于首次访谈。一些患者对自己的新情况感到担忧，他们认为解决这些问题比潜在的不依从问题更为重要。
患者对药房服务感到满意，并表示工作人员帮助他们顺利开始服用新药。在随访访谈方面存在一些挑战。一些患者还将从更侧重于解决其特定医疗问题的服务中受益。
