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[电子处方:确保更好地坚持治疗的局限性及可能的改进措施]

[Electronic prescription: limitations and possible improvements to ensure greater adherence to treatments].

作者信息

García Alfaro Irene, Carballeira Rodríguez José Daniel

机构信息

Programa de Doctorado en Farmacia. Universidad de Granada. Granada. España.

Farmacia de José Daniel Carballeira Rodríguez. Santander. España.

出版信息

Rev Esp Salud Publica. 2019 Sep 25;93:e201909070.

Abstract

OBJECTIVE

The electronic prescription has meant an evolution in the quality of health care, but it has a series of deficiencies that compromise the adherence to treatments. The objective of this work was to collect and group these limitations and propose the changes that could solve them.

METHODS

During 2017 and 2018, through dispensing and pharmacotherapeutic monitoring activities, incidents related to the electronic prescription were collected in a pharmacy in Santander and their causes were identified. A survey was conducted and sent to the Information Centers of the Medicines of the rest of the regions to know if the same problems were shared and the resulting data were treated by frequency distribution.

RESULTS

We detected 1,500 incidents related to the way of access to the treatment and its activation period, with the availability of the medication when the patient requested it and those in which the assessment of the problem by the doctor was essential. The survey data showed that in 100% of the CCAA the patient must return to the doctor when there is an incidence, because there is no protocol to solve it from the pharmacy.

CONCLUSIONS

These incidents compromise the adherence to treatments and the health of patients. To avoid them, we propose the elimination of the password that is necessary to access the treatment, the establishment of a minimum period of 30 days for its activation, the creation of protocols so that the pharmacist can solve problems and perform dispensations in special circumstances, and finally, the optimization of the communication between pharmacist and doctor.

摘要

目的

电子处方意味着医疗保健质量的一次进步,但它存在一系列缺陷,会影响治疗依从性。这项工作的目的是收集并归类这些局限性,并提出能够解决这些问题的变革措施。

方法

在2017年和2018年期间,通过配药和药物治疗监测活动,在桑坦德的一家药房收集了与电子处方相关的事件,并确定了其原因。开展了一项调查并发送给其他地区药品信息中心,以了解是否存在同样的问题,所得数据通过频率分布进行处理。

结果

我们检测到1500起与治疗获取方式及其激活期、患者要求时药物的可获得性以及医生对问题的评估至关重要的事件。调查数据显示,在100%的自治区,出现问题时患者必须返回医生处,因为药房没有解决问题的方案。

结论

这些事件会影响治疗依从性和患者健康。为避免这些问题,我们建议取消获取治疗所需的密码,设定至少30天的激活期,制定方案以便药剂师能够解决问题并在特殊情况下进行配药,最后,优化药剂师与医生之间的沟通。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9ed/11582856/9389b725750e/1135-5727-resp-93-e201909070-g002.jpg

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