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针对无家可归者的临床药学干预:服务设计与开发中患者观点的评估

Clinical Pharmacy Intervention for Persons Experiencing Homelessness: Evaluation of Patient Perspectives in Service Design and Development.

作者信息

Jagpal Parbir, Barnes Nigel, Lowrie Richard, Banerjee Amitava, Paudyal Vibhu

机构信息

School of Pharmacy, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.

Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham B23 6AL, UK.

出版信息

Pharmacy (Basel). 2019 Nov 13;7(4):153. doi: 10.3390/pharmacy7040153.

Abstract

Persons experiencing homelessness have a high prevalence of severe mental health problems, alcohol dependence, substance misuse and infectious hepatitis C, and face up to twelve times higher mortality rates compared to the general population. They also face barriers to accessing healthcare. However, clinical pharmacy services are currently not available to homeless populations in England. The aim of this study was to conduct public involvement sessions with persons experiencing homelessness with a view to inform the design of patient-centred clinical pharmacy healthcare services. Qualitative methodology was used, using a focus group with homeless persons from emergency shelters and one to one engagement with those sleeping rough, using a topic guide. A total of nine homeless persons took part-seven males and two females. The participants of the sessions said that patient-centred clinical pharmacy services delivered for homeless persons would address many of their unmet needs around access to medicines, their understanding of prescribed medicines and holistic management of their health. The service would be able to make a positive impact on their health outcomes by screening for health conditions, facilitating better integration across services, referral and liaison with other services, and minimising misuse of prescribed medicines. The findings of this study will be used to inform the development, implementation and evaluation of a patient-centred clinical pharmacy service tailored to meet the specific needs of the homeless population.

摘要

无家可归者中严重心理健康问题、酒精依赖、药物滥用和丙型肝炎感染的患病率很高,与普通人群相比,死亡率高达12倍。他们在获得医疗保健方面也面临障碍。然而,目前英格兰的无家可归者无法获得临床药学服务。本研究的目的是与无家可归者开展公众参与活动,以便为以患者为中心的临床药学医疗服务设计提供信息。采用定性方法,使用主题指南,与来自紧急避难所的无家可归者进行焦点小组讨论,并与露宿者进行一对一交流。共有9名无家可归者参与,其中7名男性和2名女性。参与活动的人员表示,为无家可归者提供的以患者为中心的临床药学服务将满足他们在药品获取、对处方药的理解以及整体健康管理等方面许多未得到满足的需求。该服务将能够通过筛查健康状况、促进各服务之间更好的整合、与其他服务进行转诊和联络以及尽量减少处方药的滥用,对他们的健康结果产生积极影响。本研究的结果将用于为量身定制以满足无家可归者特定需求的以患者为中心的临床药学服务的开发、实施和评估提供信息。

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