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泰国社区药剂师在非甾体抗炎药风险筛查与沟通中作用的评估

Evaluation of community pharmacists' roles in screening and communication of risks about non-steroidal anti-inflammatory drugs in Thailand.

作者信息

Phueanpinit Pacharaporn, Pongwecharak Juraporn, Krska Janet, Jarernsiripornkul Narumol

机构信息

1Graduate Student, Faculty of Pharmaceutical Sciences,Khon Kaen University,Khon Kaen,Thailand.

2Lecturer, Faculty of Pharmacy,Thammasat University,Pathumthani,Thailand.

出版信息

Prim Health Care Res Dev. 2018 Nov;19(6):598-604. doi: 10.1017/S1463423618000142. Epub 2018 Mar 19.

Abstract

AimThis study aimed to explore community pharmacists' roles on screening for risk factors, providing safety information-related non-steroidal anti-inflammatory drugs (NSAIDs) to patients. BACKGROUND: NSAIDs are widely dispensed without a prescription from pharmacies in Thailand, while they are frequently reported as causing adverse events. METHODS: Self-administered questionnaires were distributed to all accredited pharmacies in Thailand, inviting the main pharmacist in each pharmacy to participate in this study.FindingsOut of 406 questionnaires distributed, 159 were returned (39.2%). Almost all pharmacists claimed to engage in NSAID dispensing practice, but not all of them provided relevant good practice, such as, screening for risk factors (56.3-95.5%), communication on adverse drug reactions (ADRs) (36.9-63.2%) and ADR management (58.9-79.7%), history of gastrointestinal (GI) problems was frequently mentioned for screening, but many pharmacists did not screen for history of NSAID use (24.7-35.5%), older age (45.2-48.9%), concomitant drug (63.7%), and problems of cardiovascular (24.1%), renal (34.9-43.3%), and liver systems (60.3-61.0%). Male pharmacists were significantly less likely to inform users of non-selective NSAIDs about ADRs [odds ratio (OR) 0.44], while provision of information about selective NSAID ADRs was higher among pharmacy owners (OR 2.28), pharmacies with more pharmacists (OR 3.18), and lower in pharmacies with assistants (OR 0.41). Screening for risk factors, and risk communication about NSAIDs were not generally conducted in Thai accredited community pharmacists, nor were NSAID complications fully communicated. Promoting of community pharmacists' roles in NSAID dispensing should give priority to improving, especially in high-risk patients for taking NSAIDs.

摘要

目的

本研究旨在探讨社区药剂师在筛查危险因素、向患者提供与安全信息相关的非甾体抗炎药(NSAIDs)方面的作用。

背景

在泰国,NSAIDs无需处方即可在药店广泛配药,而它们经常被报告会引起不良事件。

方法

向泰国所有经认可的药店发放自填式问卷,邀请每家药店的主要药剂师参与本研究。

结果

在发放的406份问卷中,有159份被退回(39.2%)。几乎所有药剂师都声称参与了NSAIDs配药实践,但并非所有人都提供了相关的良好做法,例如,筛查危险因素(56.3 - 95.5%)、药物不良反应(ADR)沟通(36.9 - 63.2%)和ADR管理(58.9 - 79.7%),筛查时经常提到胃肠道(GI)问题病史,但许多药剂师没有筛查NSAIDs使用史(24.7 - 35.5%)、年龄较大(45.2 - 48.9%)、合并用药(63.7%)以及心血管(24.1%)、肾脏(34.9 - 43.3%)和肝脏系统问题(60.3 - 61.0%)。男性药剂师告知非选择性NSAIDs使用者ADR的可能性显著较低[比值比(OR)0.44],而药房老板(OR 2.28)、药剂师较多的药房(OR 3.18)提供选择性NSAIDs ADR信息的比例较高,有助理的药房提供此类信息的比例较低(OR 0.41)。泰国经认可的社区药剂师通常不进行危险因素筛查和NSAIDs风险沟通,NSAIDs并发症也未得到充分沟通。促进社区药剂师在NSAIDs配药中的作用应优先改进,尤其是在服用NSAIDs的高危患者中。

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