Flanagan Priti S, Barns Andrea
Pharmacy Community Programs, Lower Mainland Pharmacy Services, Langley, BC, Canada,
Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada,
Integr Pharm Res Pract. 2018 Oct 1;7:141-159. doi: 10.2147/IPRP.S148266. eCollection 2018.
The scope of clinical pharmacy services available in outpatient settings, including home care, continues to expand. This review sought to identify the evidence to support pharmacist provision of clinical pharmacy services in a home care setting. Seventy-five reports were identified in the literature that provided evaluation and description of clinical pharmacy home visit services available around the world. Based on results from randomized controlled trials, pharmacist home visit interventions can improve patient medication adherence and knowledge, but have little impact on health care resource utilization. Other literature reported benefits of a pharmacist home visit service such as patient satisfaction, improved medication appropriateness, increased persistence with warfarin therapy, and increased medication discrepancy resolution. Current perspectives to consider in establishing or evaluating clinical pharmacy services offered in a home care setting include: staff competency, ideal target patient population, staff safety, use of technology, collaborative relationships with other health care providers, activities performed during a home visit, and pharmacist autonomy.
包括居家护理在内的门诊环境中可提供的临床药学服务范围不断扩大。本综述旨在寻找证据,以支持药剂师在居家护理环境中提供临床药学服务。文献中确定了75份报告,这些报告对世界各地现有的临床药学家访服务进行了评估和描述。基于随机对照试验的结果,药剂师家访干预可提高患者的用药依从性和知识水平,但对医疗资源利用影响不大。其他文献报道了药剂师家访服务的益处,如患者满意度提高、用药合理性改善、华法林治疗持续性增加以及用药差异解决率提高。在建立或评估居家护理环境中提供的临床药学服务时需要考虑的当前观点包括:工作人员能力、理想的目标患者群体、工作人员安全、技术使用、与其他医疗服务提供者的合作关系、家访期间开展的活动以及药剂师的自主权。