Hefti Erik, Remington Michael, Lavallee Charles
Department of Pharmaceutical Services, Sisters of Charity Hospital, St. Joseph Campus. Cheektowaga, NY (United States).
Department of Pharmaceutical Services, Sisters of Charity Hospital, Main Street Campus. Buffalo, NY (United States).
Pharm Pract (Granada). 2017 Oct-Dec;15(4):1071. doi: 10.18549/PharmPract.2017.04.1071. Epub 2017 Dec 18.
Pharmacist involvement has been shown to improve various aspects of patient care. Patients undergoing knee and hip replacement surgery generally experience post-operative pain and discomfort. Pain control can impact patient satisfaction, as reported by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.
The current pilot study aims to measure the potential impact that incorporating pharmacists into preoperative patient education programs has on the response to select HCAHPS questions.
Patient responses to two select HCAHPS questions related to pain were recorded for a year prior to pharmacist involvement in a comprehensive preoperative patient education program (2012) and a year after pharmacists became actively involved (2013).
In all reporting surgical patients, there was a modest 3.68% improvement in mean scores reflecting patient's feelings that hospital staff did "everything they could" to attend to their pain (mean=3.66, SD=0.63 versus mean=3.80, SD=0.43, p=0.018, Mann-Whitney U test). There was a non-significant 2.98% improvement in scores reflecting the level that pain was "well controlled" (mean=3.54, SD=0.651 versus mean=3.65, SD=0.554, p=0.069, Mann-Whitney U test) in surgical patients.
The results suggest comprehensive pharmacist involvement in patient education prior to joint replacement surgery may impact HCAHPS scores related to pain control. While the observed potential improvements were modest, the current results justify larger, multi-institution prospective studies to better elucidate the impact pharmacists can have on pain management in patients undergoing joint replacement.
药剂师的参与已被证明可改善患者护理的各个方面。接受膝关节和髋关节置换手术的患者通常会经历术后疼痛和不适。如医院医疗服务提供者和系统消费者评估（HCAHPS）调查所报告的，疼痛控制会影响患者满意度。
当前的试点研究旨在衡量将药剂师纳入术前患者教育计划对选定的HCAHPS问题的回答产生的潜在影响。
在药剂师参与全面的术前患者教育计划之前的一年（2012年）以及药剂师积极参与之后的一年（2013年），记录患者对两个与疼痛相关的选定HCAHPS问题的回答。
在所有报告的手术患者中，反映患者认为医院工作人员“尽其所能”处理其疼痛的平均得分有适度提高，提高了3.68%（均值=3.66，标准差=0.63，对比均值=3.80，标准差=0.43，p=0.018，曼-惠特尼U检验）。反映疼痛“得到良好控制”程度的得分在手术患者中有2.98% 的提高，但无统计学意义（均值=3.54，标准差=0.651，对比均值=3.65，标准差=0.554，p=0.069，曼-惠特尼U检验）。
结果表明药剂师全面参与关节置换手术前的患者教育可能会影响与疼痛控制相关的HCAHPS评分。虽然观察到的潜在改善幅度不大，但当前结果证明有必要开展更大规模的多机构前瞻性研究，以更好地阐明药剂师对接受关节置换手术患者的疼痛管理可能产生的影响。
