Department of Pharmacokinetics and Clinical Pharmacy, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia.
Department of Pharmacokinetics and Clinical Pharmacy, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia.
Patient Educ Couns. 2017 Sep;100(9):1714-1719. doi: 10.1016/j.pec.2017.05.001. Epub 2017 May 1.
To evaluate elderly polypharmacy patients' needs and concerns regarding medication through the Structured Patient-Pharmacist Consultation (SPPC).
Older patients on chronic treatment with ≥5 medications were asked to fill in the SPPC form at home. A consultation with the community pharmacist, structured according to patient's answers, followed within 2-4 weeks. Logistic regression associated patients' individual treatment with care issues and consultation outcomes.
Out of 440 patients, 39.5% experienced problems, and 46.1% had concerns about medication use. 122 patients reported reasons for discontinuing treatment. The main outcome of the consultation was a better understanding of medication use (75.5%). Side effects and/or non-adherence were identified in 50% of patients, and 26.6% were referred to the doctor. Atrial fibrillation, COPD, anticoagulants, benzodiazepines, and beta agonists/corticosteroids were associated with problems during medication use. Patients with diabetes improved their understanding of medication use significantly.
Patients on benzodiazepines, anticoagulants, and beta agonists/corticosteroids, with atrial fibrillation and/or COPD, may have a higher potential for non-adherence. Counseling patients based on the SPPC model may be particularly useful for patients with diabetes.
The SPPC model is a useful tool for counseling based on patient needs.
通过结构化患者-药剂师咨询(SPPC)评估老年多药治疗患者对药物治疗的需求和关注。
询问正在接受慢性治疗且服用≥5 种药物的老年患者在家填写 SPPC 表格。根据患者的回答,在 2-4 周内进行社区药剂师咨询。逻辑回归将患者的个体治疗与护理问题和咨询结果相关联。
在 440 名患者中,39.5%的患者出现问题,46.1%的患者对药物使用存在担忧。122 名患者报告了停药的原因。咨询的主要结果是更好地理解药物使用(75.5%)。50%的患者出现了药物副作用和/或不遵医嘱,26.6%的患者被转介给医生。房颤、COPD、抗凝剂、苯二氮䓬类药物和β激动剂/皮质类固醇与用药期间出现的问题相关。糖尿病患者对药物使用的理解明显提高。
服用苯二氮䓬类药物、抗凝剂和β激动剂/皮质类固醇的患者,合并房颤和/或 COPD,可能有更高的不遵医嘱风险。基于 SPPC 模型对患者进行咨询可能对糖尿病患者特别有用。
SPPC 模型是一种基于患者需求进行咨询的有用工具。