鼻炎负担与社区药房药物管理的影响。
The Burden of Rhinitis and the Impact of Medication Management within the Community Pharmacy Setting.
机构信息
Quality Use of Respiratory Medicine Group, Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia.
Quality Use of Respiratory Medicine Group, Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia.
出版信息
J Allergy Clin Immunol Pract. 2018 Sep-Oct;6(5):1717-1725. doi: 10.1016/j.jaip.2018.01.028. Epub 2018 Mar 29.
BACKGROUND
The burden of rhinitis is high. It is unknown to what extent this burden is related to inappropriate medication use.
OBJECTIVE
This study aimed to identify the way in which people with rhinitis medicate their condition and to evaluate the appropriateness of this medication management.
METHODS
Pharmacy customers who visited Sydney metropolitan community pharmacies and purchased medication for nasal symptoms were the sampling frame for this study. To determine the condition for which the participants were seeking medication and the appropriateness of their medication selection, the following data were collected with a researcher-administered questionnaire: participant's demographics, symptoms, medication selected. An expert panel of clinical researcher pharmacists and specialist respiratory physician evaluated the appropriateness of medication selection based on the Allergic Rhinitis and its Impact on Asthma international guidelines.
RESULTS
Two hundred and ninety-six participants were recruited from 8 pharmacies; 63.2% had a doctor's diagnosis for the symptoms for which they were selecting treatment. Seventy percent of participants self-selected their medications. Seventy-one percent of the participants were identified as having rhinitis. Overall, 16.5% of participants who had rhinitis selected optimal medications. Sixteen percent of participants with allergic rhinitis reported wheezing (6.3% selected optimal medications).
CONCLUSIONS
The majority of the participants with rhinitis selected suboptimal medications from community pharmacy highlighting the significant burden of rhinitis in community pharmacy and the contribution of medication management. Pharmacists need to take a proactive and evidence-based role in the management of rhinitis supported by clinical pathways when need to be articulated and promoted in all rhinitis guidelines.
背景
鼻炎负担很高。目前尚不清楚这种负担在多大程度上与不当用药有关。
目的
本研究旨在确定鼻炎患者的用药方式，并评估其药物管理的恰当性。
方法
本研究以悉尼市区社区药房的顾客为抽样框，这些顾客在购买治疗鼻部症状的药物时参与了研究。为了确定参与者所寻求的病症以及他们的药物选择是否恰当，我们使用研究者管理的问卷收集了以下数据：参与者的人口统计学特征、症状、所选择的药物。一个由临床研究药剂师和呼吸科专家组成的专家小组根据《变应性鼻炎及其对哮喘的影响国际指南》评估了药物选择的恰当性。
结果
从 8 家药店招募了 296 名参与者；63.2%的参与者有医生诊断其正在治疗的症状。70%的参与者自行选择药物。71%的参与者被诊断为鼻炎。总体而言，16.5%的鼻炎患者选择了最佳药物。16%的过敏性鼻炎患者报告有喘息（6.3%选择了最佳药物）。
结论
大多数鼻炎患者在社区药房选择了不理想的药物，这突出了社区药房中鼻炎的严重负担，以及药物管理的重要性。药剂师需要在所有鼻炎指南中阐明和推广时，在临床路径的支持下，积极主动地、基于证据地参与鼻炎管理。
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