安大略省药物检查计划的真实世界经验分析。

Analysis of Real-World Experiences with the Ontario MedsCheck Program.

作者信息

Graham Ashley, Bartle William, Madorin Patti, Teo Vincent, Diamantouros Artemis

机构信息

, PharmD, ACPR, was, at the time of this study, a pharmacy resident at the Sunnybrook Health Sciences Centre, Toronto, Ontario. She is now with Women's College Hospital, Toronto, Ontario.

, BScPhm, PharmD, FCSHP, is with the Sunnybrook Health Sciences Centre, Toronto, Ontario.

出版信息

Can J Hosp Pharm. 2019 Jul-Aug;72(4):295-300. Epub 2018 Aug 31.

PMID:31452541

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6699860/

Abstract

BACKGROUND

The Ontario MedsCheck program was introduced in April 2007, with enhancements to strengthen the program made in October 2016. Previous literature has characterized patients who received the service before the enhancements and described the experiences of community pharmacists and physicians, but the experiences of participants in the enhanced MedsCheck program and those of hospital pharmacists and pharmacy technicians have not been explored.

OBJECTIVES

This study was designed to describe and compare the demographic and clinical characteristics of patients admitted to Sunnybrook Health Sciences Centre (SHSC) who had received a MedsCheck before and after the program enhancements of 2016. The study also aimed to describe the experiences of patients, hospital pharmacists, and pharmacy technicians with the MedsCheck program.

METHODS

Chart reviews were completed to identify and characterize patients who had received a MedsCheck and were admitted to SHSC between March and May 2016 (retrospective cohort) and between March and May 2017 (prospective cohort). Patients were interviewed and focus groups were conducted with pharmacy staff to explore their experiences with the MedsCheck program.

RESULTS

MedsChecks had been performed for 321 (14.5%) of 2216 patients in the retrospective cohort and 172 (6.8%) of 2547 patients in the prospective cohort, an absolute decline of 7.7% after the 2016 enhancements. Patient characteristics were similar between the 2 cohorts. Patients' experiences were varied, but because of low enrolment in the interview process ( = 3), it was difficult to identify and summarize common themes. The analysis of focus groups involving pharmacy staff ( = 27 participants) revealed that the benefits of MedsChecks depended on quality and access, and also identified common barriers and opportunities for future enhancements.

CONCLUSIONS

Patient interviews revealed the features of the program that patients valued. Pharmacy staff identified several benefits and barriers encountered when using MedsChecks. These findings can guide clinicians in optimal application of the current MedsCheck program and can inform subsequent program revisions.

摘要

背景

安大略省药物检查项目于2007年4月推出，并于2016年10月进行了强化改进。以往文献描述了在强化改进之前接受该服务的患者情况，以及社区药剂师和医生的经历，但强化后的药物检查项目参与者以及医院药剂师和药房技术员的经历尚未得到探讨。

目的

本研究旨在描述和比较2016年项目强化改进前后在桑尼布鲁克健康科学中心（SHSC）住院且接受过药物检查的患者的人口统计学和临床特征。该研究还旨在描述患者、医院药剂师和药房技术员在药物检查项目中的经历。

方法

通过病历审查来识别和描述在2016年3月至5月（回顾性队列）以及2017年3月至5月（前瞻性队列）期间接受过药物检查并入住SHSC的患者。对患者进行了访谈，并与药房工作人员开展了焦点小组讨论，以探讨他们在药物检查项目中的经历。

结果

回顾性队列中的2216名患者中有321名（14.5%）接受了药物检查，前瞻性队列中的2547名患者中有172名（6.8%）接受了药物检查，2016年强化改进后绝对下降了7.7%。两个队列的患者特征相似。患者的经历各不相同，但由于访谈过程中的参与率较低（n = 3），难以识别和总结共同主题。对涉及药房工作人员的焦点小组（n = 27名参与者）的分析表明，药物检查的益处取决于质量和可及性，同时也确定了常见障碍以及未来改进的机会。