Zavala-González Marco Antonio, Cabrera-Pivaral Carlos Enrique, Orozco-Valerio María de Jesús, Ramos-Herrera Igor Martín
Programa de Doctorado en Ciencias de la Salud Pública, Departamento de Salud Pública, División de Disciplinas para el Desarrollo, Promoción y Preservación de la Salud, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México.
Programa de Doctorado en Ciencias de la Salud Pública, Departamento de Salud Pública, División de Disciplinas para el Desarrollo, Promoción y Preservación de la Salud, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México.
Aten Primaria. 2017 Jan;49(1):13-20. doi: 10.1016/j.aprim.2016.02.006. Epub 2016 Jun 11.
To determine the effectiveness of interventions for improving drug prescribing in Primary Health Care units.
Systematic review and meta-analysis.
Searches were made in MedLine, ScienceDirect, Springer, SciELO, Dialnet, RedALyC and Imbiomed, in Spanish, English and Portuguese, using keywords "drug prescribing", "intervention studies" and "primary health care", indexed in each data base up to August 2014.
Experimental and quasi-experimental studies were included that had a CASP-score>5 and that evaluated effect of any type intervention on the quality of drug prescription in Primary Health Care.
A total of 522 articles were found, and an analysis was performed on 12 that reported 17 interventions: 64.7% educational, 23.5% incorporating pharmacists into the health team, and 11.8% on the use of computer applications. The strong "intervention/improvement" associations were educational interventions OR=2.47 (95% CI; 2.28 - 2.69), incorporation of pharmacists OR=3.28 (95% CI; 2.58 4.18), and use of computer applications OR=10.16 (95% CI; 8.81 -11.71).
The use of interventions with computer applications showed to be more effective than educational interventions and incorporation pharmacists into the health team. Future studies are required that include economic variables such as, implementation costs, drug costs and other expenses associated with health care and treatment of diseases.
确定在初级卫生保健单位改善药物处方的干预措施的有效性。
系统评价和荟萃分析。
在MedLine、ScienceDirect、Springer、SciELO、Dialnet、RedALyC和Imbiomed中进行检索,使用西班牙语、英语和葡萄牙语,关键词为“药物处方”“干预研究”和“初级卫生保健”,检索截至2014年8月每个数据库中编入索引的文献。
纳入CASP评分>5的实验性和准实验性研究,这些研究评估了任何类型干预对初级卫生保健中药物处方质量的影响。
共找到522篇文章,对其中12篇报告了17种干预措施的文章进行了分析:64.7%为教育性干预,23.5%为将药剂师纳入卫生团队,11.8%为使用计算机应用程序。强有力的“干预/改善”关联为教育性干预,比值比(OR)=2.47(95%置信区间[CI]:2.28 - 2.69);纳入药剂师,OR=3.28(95%CI:2.58 - 4.18);使用计算机应用程序,OR=10.16(95%CI:8.81 - 11.71)。
使用计算机应用程序的干预措施比教育性干预以及将药剂师纳入卫生团队更有效。未来需要开展包括经济变量(如实施成本、药物成本以及与疾病医疗保健相关的其他费用)的研究。