Messerli Markus, Vriends Noortje, Hersberger Kurt E
Pharmaceutical Care Research Group, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland.
Division of Clinical Psychology, Department of Psychology, University of Basel, Basel, Switzerland.
Patient Prefer Adherence. 2018 Jun 19;12:1071-1078. doi: 10.2147/PPA.S160789. eCollection 2018.
Since 2010, Swiss pharmacists have been offering their patients a Polymedication Check (PMC), a new cognitive pharmacy service in the form of a medication review for patients taking ≥4 prescribed medicines for a period >3 months. While a first publication of this project reported on the impact of the PMC on patients' adherence, the present paper focuses on humanistic outcomes.
This randomized controlled trial was conducted in 54 Swiss community pharmacies. After recruitment, the intervention group underwent a PMC in the pharmacy (T-0) and 28 weeks after T-0 (T-28), while the control group did not receive the PMC until 28 weeks after the study started (T-28). A clinical psychologist, blinded to the intervention, interviewed the patients 2 weeks (T-2) and 16 weeks (T-16) after T-0. Interviewer and patient both rated patient's knowledge of own medicines use. Furthermore, patients reported satisfaction with their pharmacy and appraisal of their medicines use. The availability of a written medication plan was assessed at T-16. Acceptance of the service was measured using a patient's self-report questionnaire at T-28.
General linear model analysis for knowledge about medicines revealed a significant effect on the factor "group" (=5.86, =0.016), indicating that the intervention group had higher ratings for knowledge about their medication at T-2 and T-16 compared to controls. The majority (83%) of patients judged the counseling by the pharmacist as being helpful for their daily medication management. Availability of a written medication plan was comparable in both groups (52.5% vs 52.7%, >0.05).
For the first time, the benefits of a complex pharmacist-led intervention were evaluated in Swiss primary care with a randomized controlled trial. The PMC increased patients' subjective knowledge of their medicines compared to no medication review. The effect remained sustainable over time. Recommendations resulting from the pharmacist-led service were highly appreciated by the patients.
自2010年以来，瑞士药剂师一直在为患者提供多药核查（PMC）服务，这是一种新的认知药学服务，形式为对服用≥4种处方药且服药时间超过3个月的患者进行用药评估。虽然该项目的首次发表报告了PMC对患者依从性的影响，但本文重点关注人文结局。
这项随机对照试验在54家瑞士社区药房进行。招募后，干预组在药房接受了一次PMC（T-0），并在T-0后28周（T-28）再次接受，而对照组直到研究开始后28周（T-28）才接受PMC。一名对干预不知情的临床心理学家在T-0后2周（T-2）和16周（T-16）对患者进行访谈。访谈者和患者都对患者对自身用药情况的了解程度进行评分。此外，患者报告了对药房的满意度以及对自身用药情况的评价。在T-16评估书面用药计划的可用性。在T-28使用患者自我报告问卷测量对该服务的接受度。
对用药知识的一般线性模型分析显示，“组”因素有显著影响（=5.86，=0.016），表明干预组在T-2和T-16时对其用药知识的评分高于对照组。大多数（83%）患者认为药剂师的咨询对他们的日常用药管理有帮助。两组书面用药计划的可用性相当（52.5%对52.7%，>0.05）。
首次在瑞士初级保健中通过随机对照试验评估了由药剂师主导的复杂干预措施的益处。与未进行用药评估相比，PMC提高了患者对其药物的主观认识。随着时间的推移，这种效果仍然持续。患者对药剂师主导的服务所产生的建议评价很高。
