School of Health Sciences, University of Surrey, UK.
School of Health Sciences, University of Surrey, UK.
Health Policy. 2018 Dec;122(12):1333-1339. doi: 10.1016/j.healthpol.2018.10.004. Epub 2018 Oct 10.
Making best use of existing skills to increase service capacity is a global challenge. The aim was to systematically review physiotherapy and podiatrist prescribing and medicines management activity, including evidence of impact on patient care, levels of knowledge and attitudes towards extended medicines role.
A search of MEDLINE, CINAHL, and Cochrane databases, using terms to identify prescribing and medicines management across a range of roles, was conducted from January 1985 to May 2016 for physiotherapy, and January 1968 to May 2016 for podiatry. Hand searching of citations and databases from professional organisations was undertaken. Data were extracted and analysed descriptively, and quality appraised by 2 reviewers using the mixed methods appraisal tool.
1316 papers were identified, and 21 included in the review. No studies were identified that reported prescribing and no studies specific to podiatry met the inclusion criteria. Physiotherapists were highly involved in administering medicines, providing medicines advice, and recommending new medicines. Patient satisfaction, cost and outcomes were equivalent when comparing physiotherapist-led injection therapy to traditional care. Pharmacology knowledge was variable and unmet training needs identified.
Medicines management practices were identified in physiotherapy and positive outcomes of extended scope physiotherapy. There was a lack of evidence regarding podiatric practice. Review of educational preparation for medicines management is recommended along with evaluation of medicines management practice.
充分利用现有技能来提高服务能力是全球性挑战。本研究旨在系统回顾物理治疗师和足病医生的处方和药物管理活动，包括对患者护理的影响、知识水平和对扩展药物作用的态度的证据。
从 1985 年 1 月至 2016 年 5 月，使用术语在各种角色中识别处方和药物管理，对 MEDLINE、CINAHL 和 Cochrane 数据库进行了搜索；从 1968 年 1 月至 2016 年 5 月，对足病学进行了搜索。对手册搜索了专业组织的引文和数据库。数据采用混合方法评价工具由 2 名评审员进行描述性提取和分析，并进行质量评价。
共确定了 1316 篇论文，其中 21 篇纳入了综述。没有发现报告处方的研究，也没有专门针对足病学的研究符合纳入标准。物理治疗师高度参与管理药物、提供药物建议和推荐新药。与传统护理相比，患者对物理治疗师主导的注射治疗的满意度、成本和结果是相当的。药理学知识存在差异，培训需求未得到满足。
在物理治疗中发现了药物管理实践，并且扩展范围的物理治疗有积极的效果。但足病学实践的证据不足。建议审查药物管理教育准备情况，并评估药物管理实践。
