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将居家护理药剂师整合到养老院中以改善药品的合理使用:一项非随机对照试点试验的研究方案。

Feasibility of Integrating Residential Care Pharmacists into Aged Care Homes to Improve Quality Use of Medicines: Study Protocol for a Non-Randomised Controlled Pilot Trial.

机构信息

Faculty of Health, Discipline of Pharmacy, University of Canberra, Bruce CBR 2617, Australia.

Faculty of Health, Discipline of Nursing, University of Canberra, Bruce CBR 2617, Australia.

出版信息

Int J Environ Res Public Health. 2018 Mar 12;15(3):499. doi: 10.3390/ijerph15030499.

Abstract

Older adults are particularly susceptible to iatrogenic disease and communicable diseases, such as influenza. Prescribing in the residential aged care population is complex, and requires ongoing review to prevent medication misadventure. Pharmacist-led medication review is effective in reducing medication-related problems; however, current funding arrangements specifically exclude pharmacists from routinely participating in resident care. Integrating an on-site clinical pharmacist into residential care teams is an unexplored opportunity to improve quality use of medicines in this setting. The primary objective of this pilot study is to investigate the feasibility of integrating a residential care pharmacist into the existing care team. Secondary outcomes include incidence of pharmacist-led medication review, and incidence of potential medication problems based on validated prescribing measures. This is a cross-sectional, non-randomised controlled trial with a residential care pharmacist trialled at a single facility, and a parallel control site receiving usual care and services only. The results of this hypothesis-generating pilot study will be used to identify clinical outcomes and direct future larger scale investigations into the implementation of the novel residential care pharmacist model to optimise quality use of medicines in a population at high risk of medication misadventure.

摘要

老年人特别容易受到医源性疾病和传染病的影响,如流感。为居住在养老院的老年人开处方很复杂,需要持续审查以防止用药失误。药剂师主导的药物审查在减少与药物相关的问题方面非常有效;然而,目前的资金安排特别排除了药剂师定期参与居民护理。将临床药剂师纳入养老院的护理团队是改善该环境中药物合理使用的一个尚未开发的机会。本试点研究的主要目的是调查将养老院药剂师纳入现有护理团队的可行性。次要结果包括药剂师主导的药物审查的发生率,以及基于验证的处方措施的潜在药物问题的发生率。这是一项在单个机构中对养老院药剂师进行试验的横断面、非随机对照试验,以及一个平行对照点仅接受常规护理和服务。这项产生假设的试点研究的结果将用于确定临床结果,并指导未来更大规模的调查,以实施新的养老院药剂师模式,优化高用药失误风险人群的药物合理使用。

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