Heck Taryn, Gunther Mary, Bresee Lauren, Mysak Tania, Mcmillan Chloe, Koshman Sheri
Taryn Heck, B.Sc.Pharm., ACPR, is Clinical Pharmacist, University of Alberta Hospital, Edmonton, Canada. Mary Gunther, B.Sc. Pharm., ACPR, is Clinical Practice Leader-Pediatric Critical Care, Alberta Health Services (AHS), Edmonton. Lauren Bresee, B.Sc. Pharm., M.Sc., Ph.D., ACPR, is Drug Stewardship Pharmacist-Calgary Zone, AHS, and Adjunct Assistant Professor, Department of Community Health Sciences, University of Calgary, Calgary, Canada. Tania Mysak, B.S.P., Pharm.D., is Director of Practice, Pharmacy Services, AHS, Edmonton. Chloe Mcmillan, B.Sc.Pharm., is Clinical Pharmacist, University of Alberta Hospital. Sheri Koshman, B.Sc.Pharm., Pharm.D., ACPR, is Associate Professor of Medicine, Division of Cardiology, Walter C. Mackenzie Health Sciences Centre, University of Alberta, Edmonton.
Am J Health Syst Pharm. 2015 Dec 15;72(24):2166-75. doi: 10.2146/ajhp150080.
Results of a survey to determine the frequency of prescribing by Canadian hospital pharmacists with independent prescribing authority are reported.
A Web-based questionnaire was used to collect data on the prescribing activities of a designated group of hospital-affiliated pharmacists in the province of Alberta who had been granted "additional prescribing authorization" (APA) through a peer-review process and were providing clinical pharmacy services in inpatient and/or outpatient settings at the time of the survey (January-March 2014). Descriptive statistics and logistic regression analysis were used to determine the median weekly frequency of prescribing, factors associated with increased use of APA, and perceived prescribing barriers and enablers.
The survey response rate was about 50% (77 of 153 eligible pharmacists). The median self-reported number of prescriptions and medication orders written during an average week was 4.2 (interquartile range, 2.0-10.0) per 10 patients. Antibiotics and anticoagulants were the most commonly prescribed medications. Interdisciplinary care team dynamics was rated as a leading enabler of prescribing but also a leading barrier to the exercise of APA. The greatest motivators to apply for APA were the potential for increased efficiency and the potential for enhanced patient care.
The survey results indicated that, in an average week, hospital pharmacists with APA prescribed for almost half of the patients they cared for as part of the interdisciplinary team. Prescribing most frequently occurred after team discussion and most often involved adjusting dosages based on organ function and clinical assessment.
报告一项旨在确定具有独立处方权的加拿大医院药剂师处方频率的调查结果。
采用基于网络的问卷收集艾伯塔省一组指定的医院附属药剂师的处方活动数据，这些药剂师通过同行评审程序获得了“额外处方授权”（APA），并在调查期间（2014年1月至3月）在住院和/或门诊环境中提供临床药学服务。使用描述性统计和逻辑回归分析来确定每周处方的中位数频率、与APA使用增加相关的因素以及感知到的处方障碍和促进因素。
调查回复率约为50%（153名符合条件的药剂师中有77名回复）。每10名患者平均每周自我报告开具的处方和用药医嘱数量中位数为4.2（四分位间距，2.0 - 10.0）。抗生素和抗凝剂是最常开具的药物。跨学科护理团队动态被评为处方的主要促进因素，但也是行使APA的主要障碍。申请APA的最大动机是提高效率的潜力和加强患者护理的潜力。
调查结果表明，平均每周，拥有APA的医院药剂师为他们作为跨学科团队一部分所护理的近一半患者开处方。处方最常在团队讨论后开出，并且最常涉及根据器官功能和临床评估调整剂量。
