East Kent Hospitals University NHS Foundation Trust, Ethelbert Road, Canterbury, CT1 3NG, UK.
School of Pharmacy, University of Bradford, Bradford, BD7 1DP, UK.
Int J Clin Pharm. 2019 Aug;41(4):1110-1117. doi: 10.1007/s11096-019-00838-y. Epub 2019 May 9.
Background The post-discharge Medicines-Use-Review (dMUR) is a commissioned service in England and Wales whereby community pharmacists facilitate patients' understanding of their medicines and resolve any medicine-related problems. This service is poorly utilised. Objective To explore the impact of raising hospital patients' awareness of dMURs on their uptake. Setting Hospital in South East England. Method Patients on medical wards with at least one change (medicine, or dose regimen) to their admission medicines were provided with standardized written and verbal information about the service. Participants were responsible for their own medicines and anticipated that they would be discharged home. Structured telephone interviews conducted 4 weeks after discharge explored any medicine-related issues experienced, and reasons for engaging, or not, with the dMUR service. Responses to closed questions were analysed using descriptive statistics. Responses to open questions were analysed thematically. Ethics approval was obtained. Main outcome measure Proportion of patients who received a dMUR and their motivations or barriers to accessing the service. Results Hundred patients were recruited and 84 interviewed. Their mean (SD) age was 73 (11) years. They were taking a median (range) of 9 (2-19) medicines. 67% (56/84) remembered receiving information about dMURs. Nine (11%) had attempted to make an appointment although four had not received the service because the pharmacist was unavailable. Most (88%) were not planning to access the service. The most common reason given was poor morbidity or mobility (13/31, 42%). Conclusion The use of written and verbal information to encourage patients to use the dMUR service had minimal impact.
在英国和威尔士,出院后用药审查(dMUR)是一项委托服务,社区药剂师通过该服务帮助患者了解他们的药物并解决任何与药物相关的问题。但该服务的利用率很低。目的:探索提高住院患者对 dMUR 的认识对其使用的影响。地点:英格兰东南部的一家医院。方法:为至少有一个入院药物改变(药物或剂量方案)的内科病房患者提供有关该服务的标准化书面和口头信息。患者负责自己的药物,并预计将出院回家。在出院后 4 周进行结构化电话访谈,以了解他们经历的任何与药物相关的问题,以及他们参与或不参与 dMUR 服务的原因。对封闭式问题的回答进行描述性统计分析。对开放式问题的回答进行主题分析。已获得伦理批准。主要结果指标:接受 dMUR 的患者比例及其使用该服务的动机或障碍。结果:共招募了 100 名患者,对 84 名患者进行了访谈。他们的平均(标准差)年龄为 73(11)岁。他们正在服用中位数(范围)为 9(2-19)种药物。67%(56/84)记得收到过有关 dMUR 的信息。有 9 人(11%)尝试预约,但由于药剂师无法提供服务,其中 4 人未获得该服务。大多数人(88%)不打算使用该服务。最常见的原因是病情不佳或行动不便(31 人中的 13 人,42%)。结论:使用书面和口头信息来鼓励患者使用 dMUR 服务的效果甚微。