Barry Arden R
Lower Mainland Pharmacy Services, Chilliwack, and the Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia.
Can Pharm J (Ott). 2017 Apr 6;150(3):206-215. doi: 10.1177/1715163517702167. eCollection 2017 May-Jun.
Increasing demand for ambulatory health care services has led to the development of primary care multidisciplinary teams that include pharmacists. The objective of this study was to characterize referrals to a pharmacist in a primary care clinic (PCC) based in Chilliwack, British Columbia.
This prospective cross-sectional study included all patients referred to the PCC pharmacist over 12 months (May 2015 to April 2016). Data regarding the source/reason for referral, patient demographics, medical problems/medications and number/category of identified drug therapy concerns (DTCs) were collected.
A total of 137 referrals were received. Mean age was 60 years and 59% were female. Twenty patients (15%) did not attend their appointment. Fifty-eight percent were new clinic patients identified using a Medication Risk Assessment Questionnaire (MRAQ), 30% were from PCC clinicians and 12% were from community family physicians. The most common reason for referral was for a medication review (82%). Median number of medical problems and medications per patient were 7 (interquartile range [IQR] 5) and 11 (IQR 7.5), respectively. A total of 460 DTCs were identified (median 4 per patient, IQR 3.5), of which 34% were medication without an indication and 28% an untreated indication.
The most common source of referrals to a PCC pharmacist was for medication reviews of new patients using an MRAQ. Most referred patients had multiple medical problems and polypharmacy, and few were referred for disease-specific management. The number of DTCs per patient was variable and, despite polypharmacy being commonplace, almost one-third of patients had an untreated indication.
对门诊医疗服务需求的不断增加促使了包括药剂师在内的初级保健多学科团队的发展。本研究的目的是描述不列颠哥伦比亚省奇利瓦克市一家初级保健诊所（PCC）中向药剂师的转诊情况。
这项前瞻性横断面研究纳入了在12个月内（2015年5月至2016年4月）转诊至PCC药剂师的所有患者。收集了关于转诊来源/原因、患者人口统计学信息、医疗问题/用药情况以及所识别的药物治疗问题（DTC）数量/类别的数据。
共收到137次转诊。平均年龄为60岁，59%为女性。20名患者（15%）未就诊。58%是通过用药风险评估问卷（MRAQ）识别出的新诊所患者，30%来自PCC临床医生，12%来自社区家庭医生。最常见的转诊原因是进行用药审查（82%）。每位患者的医疗问题和用药中位数分别为7个（四分位间距[IQR]为5）和11种（IQR为7.5）。共识别出460个DTC（每位患者中位数为4个，IQR为3.5），其中34%是无适应证用药，28%是适应证未治疗。
PCC药剂师转诊的最常见来源是使用MRAQ对新患者进行用药审查。大多数转诊患者有多种医疗问题且使用多种药物，很少因特定疾病管理而转诊。每位患者的DTC数量各不相同，尽管使用多种药物很常见，但近三分之一的患者有未治疗的适应证。
