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基于社区药房的干预措施以优化患者对抗抑郁药的使用及体验的开发:干预映射过程的分步演示

The Development of a Community Pharmacy-Based Intervention to Optimize Patients' Use of and Experience with Antidepressants: A Step-by-Step Demonstration of the Intervention Mapping Process.

作者信息

Santina Tania, Lauzier Sophie, Gagnon Hélène, Villeneuve Denis, Moisan Jocelyne, Grégoire Jean-Pierre, Guillaumie Laurence

机构信息

Faculty of Nursing, Université Laval, Pavillon Ferdinand-Vandry, 1050, Avenue de la Médecine, Quebec City, QC G1V 0A6, Canada.

Faculty of Pharmacy and Centre de Recherche du CHU de Québec-Université Laval, Hôpital Saint-Sacrement, 1050 Chemin Ste-Foy, Quebec City, QC G1S 4L8, Canada.

出版信息

Pharmacy (Basel). 2018 May 2;6(2):39. doi: 10.3390/pharmacy6020039.

Abstract

To describe the development of a community pharmacy-based intervention aimed at optimizing experience and use of antidepressants (ADs) for patients with mood and anxiety disorders. Intervention Mapping (IM) was used for conducting needs assessment, formulating intervention objectives, selecting change methods and practical applications, designing the intervention, and planning intervention implementation. IM is based on a qualitative participatory approach and each step of the intervention development process was conducted through consultations with a pharmacists' committee. A needs assessment was informed by qualitative and quantitative studies conducted with leaders, pharmacists, and patients. Intervention objectives and change methods were selected to target factors influencing patients' experience with and use of ADs. The intervention includes four brief consultations between the pharmacist and the patient: (1) provision of information (first AD claim); (2) management of side effects (15 days after first claim); (3) monitoring treatment efficacy (30-day renewal); (4) assessment of treatment persistence (2-month renewal, repeated every 6 months). A detailed implementation plan was also developed. IM provided a systematic and rigorous approach to the development of an intervention directly tied to empirical data on patients' and pharmacists' experiences and recommendations. The thorough description of this intervention may facilitate the development of new pharmacy-based interventions or the adaptation of this intervention to other illnesses and settings.

摘要

描述一种基于社区药房的干预措施的开发情况,该干预措施旨在优化情绪和焦虑障碍患者对抗抑郁药(ADs)的体验及使用。采用干预映射法(IM)进行需求评估、制定干预目标、选择变革方法和实际应用、设计干预措施以及规划干预实施。IM基于定性参与式方法,干预开发过程的每一步都通过与药剂师委员会协商进行。需求评估依据与领导者、药剂师和患者进行的定性和定量研究。选择干预目标和变革方法以针对影响患者对抗抑郁药体验及使用的因素。该干预措施包括药剂师与患者之间的四次简短咨询:(1)提供信息(首次开具抗抑郁药);(2)管理副作用(首次开具后15天);(3)监测治疗效果(30天续方);(4)评估治疗持续性(2个月续方,每6个月重复一次)。还制定了详细的实施计划。IM为开发与患者和药剂师的经验及建议的实证数据直接相关的干预措施提供了一种系统且严谨的方法。对该干预措施的详尽描述可能有助于开发新的基于药房的干预措施,或将此干预措施应用于其他疾病和环境。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d49c/6025435/b6901e5ae683/pharmacy-06-00039-g001.jpg

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