Erzkamp Susanne, Rose Olaf
Elefanten-Apotheke, gegr. 1575, Steinfurt, Germany.
Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Gainesville, Florida, USA.
BMJ Open. 2018 Apr 20;8(4):e019398. doi: 10.1136/bmjopen-2017-019398.
Residents of nursing homes are susceptible to risks from medication. Medication Reviews (MR) can increase clinical outcomes and the quality of medication therapy. Limited resources and barriers between healthcare practitioners are potential obstructions to performing MR in nursing homes. Focusing on frequent and relevant problems can support pharmacists in the provision of pharmaceutical care services. This study aims to develop and evaluate an algorithm-based tool that facilitates the provision of Medication Management in clinical practice.
This study is subdivided into three phases. In phase I, semistructured interviews with healthcare practitioners and patients will be performed, and a mixed methods approach will be chosen. Qualitative content analysis and the rating of the aspects concerning the frequency and relevance of problems in the medication process in nursing homes will be performed. In phase II, a systematic review of the current literature on problems and interventions will be conducted. The findings will be narratively presented. The results of both phases will be combined to develop an algorithm for MRs. For further refinement of the aspects detected, a Delphi survey will be conducted. In conclusion, a tool for clinical practice will be created. In phase III, the tool will be tested on MRs in nursing homes. In addition, effectiveness, acceptance, feasibility and reproducibility will be assessed. The primary outcome of phase III will be the reduction of drug-related problems (DRPs), which will be detected using the tool. The secondary outcomes will be the proportion of DRPs, the acceptance of pharmaceutical recommendations and the expenditure of time using the tool and inter-rater reliability.
This study intervention is approved by the local Ethics Committee. The findings of the study will be presented at national and international scientific conferences and will be published in peer-reviewed journals.
DRKS00010995.
养老院居民易受药物治疗风险影响。药物审查（MR）可改善临床结果并提高药物治疗质量。资源有限以及医护人员之间的障碍是在养老院开展MR的潜在阻碍。关注常见且相关的问题有助于药剂师提供药学服务。本研究旨在开发并评估一种基于算法的工具，以促进临床实践中的药物管理。
本研究分为三个阶段。在第一阶段，将对医护人员和患者进行半结构化访谈，并采用混合方法。将进行定性内容分析以及对养老院用药过程中问题的频率和相关性方面进行评级。在第二阶段，将对有关问题和干预措施的当前文献进行系统综述。研究结果将以叙述形式呈现。两个阶段的结果将结合起来开发MR算法。为进一步完善所发现的方面，将进行德尔菲调查。最后，将创建一个临床实践工具。在第三阶段，将该工具应用于养老院的MR测试。此外，将评估其有效性、可接受性、可行性和可重复性。第三阶段的主要结果将是使用该工具检测到的药物相关问题（DRP）的减少。次要结果将是DRP的比例、对药学建议的接受程度、使用该工具的时间消耗以及评分者间信度。
本研究干预已获当地伦理委员会批准。研究结果将在国内和国际科学会议上展示，并将发表在同行评审期刊上。
DRKS00010995。
