Schoenmakers Tim W A, Wensing Michel, De Smet Peter A G M, Teichert Martina
Department of IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
Zorgapotheek Nederland BV, Utrecht, The Netherlands.
Int J Clin Pharm. 2018 Feb;40(1):126-134. doi: 10.1007/s11096-017-0575-7. Epub 2017 Dec 5.
Background A 'Patient-Reported Outcome Measure, Inquiry into Side Effects' (PROMISE) instrument was developed for patients to report common symptoms in clinical medication reviews. Objective To determine changes in patient-reported drug-associated symptoms collected by PROMISE before and after community pharmacist-led clinical medication reviews compared with usual care. Setting Community pharmacies in the Netherlands. Methods Patients were randomised into an intervention group (IG) and a control group (CG). PROMISE was used to collect symptoms experienced during the previous month, and any suspected drug-associated symptoms from both groups at baseline and at follow-up after 3 months. IG patients received a one-time clinical medication review, while CG patients received usual care. Main outcome measure Mean number of drug-associated symptoms at follow-up. Results Measurements were completed by 78 IG and 67 CG patients from 15 community pharmacies. Mean numbers of drug-associated symptoms per patient at follow-up were 4.0 in the IG and 5.0 in the CG, with an incident rate ratio between the groups of 0.90 (95% CI 0.62-1.33). Mean numbers of drug-associated symptoms per patient reported at follow-up and persisting since baseline were 2.1 in the IG and 2.6 in the CG, with an incident rate ratio of 0.85 (95% CI 0.43-1.42). The lowest percentages of persisting drug-associated symptoms detected in the IG were 'palpitations' and 'stomach pain, dyspepsia' while in the CG they were 'stomach pain, dyspepsia' and 'trembling, shivering'. Conclusion PROMISE provided meaningful information on drug-associated symptoms in clinical medication reviews, however the number of drug-associated symptoms was not reduced by performing clinical medication reviews compared with usual care.
开发了一种“患者报告结局测量，副作用调查”（PROMISE）工具，用于让患者在临床药物审查中报告常见症状。
确定在社区药剂师主导的临床药物审查前后，通过PROMISE收集的患者报告的药物相关症状与常规护理相比的变化。
荷兰的社区药房。
将患者随机分为干预组（IG）和对照组（CG）。使用PROMISE收集前一个月经历的症状，以及两组在基线和3个月随访时任何疑似药物相关症状。IG组患者接受一次性临床药物审查，而CG组患者接受常规护理。
随访时药物相关症状的平均数量。
来自15家社区药房的78名IG组患者和67名CG组患者完成了测量。随访时IG组患者每人药物相关症状的平均数量为4.0，CG组为5.0，两组之间的发生率比为0.90（95%CI 0.62-1.33）。随访时报告且自基线以来持续存在的患者每人药物相关症状的平均数量，IG组为2.1，CG组为2.6，发生率比为0.85（95%CI 0.43-1.42）。IG组中持续存在的药物相关症状检出率最低的是“心悸”和“胃痛、消化不良”，而CG组是“胃痛、消化不良”和“颤抖、寒战”。
PROMISE在临床药物审查中提供了有关药物相关症状的有意义信息，然而与常规护理相比，进行临床药物审查并未减少药物相关症状的数量。
