Benny Gerard Nichelle, Mathers Annalise, Laeer Christoph, Lui Eric, Kontio Tom, Patel Payal, Dolovich Lisa
Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College St, Toronto, ON M5S 3M2, Canada.
Family First Health Centre, 4270 Innes Rd, Orléans, ON K4A 5E6, Canada.
Pharmacy (Basel). 2020 Jun 30;8(3):110. doi: 10.3390/pharmacy8030110.
Pharmacist-led medication reviews have been shown to improve medication management, reducing the adverse effects of polypharmacy among older adults. This paper quantitatively examines the medications, medication discrepancies and drug therapy problems of recipients in primary care. A convenience sample of 16 primary care team pharmacists in Ontario, Canada contributed data for patients with whom they conducted a medication review over a prior four-week period. Data were uploaded using electronic data capture forms and descriptive analyses were completed. Two hundred and thirty-seven patients (on average, 67.9 years old) were included in the study, taking an average of 9.2 prescription medications ( ± 4.7). Majority of these patients (83.5%) were categorized as polypharmacy patients taking at least five or more prescribed drugs per day. Just over half of the patients were classified as having a low level of medication complexity (52.3%). Pharmacists identified 2.1 medication discrepancies ( ± 3.9) and 3.6 drug therapy problems per patient ( ± 2.8). Half these patients had more than one medication discrepancy and almost every patient had a drug therapy problem identified. Medication reviews conducted by pharmacists in primary care teams minimized medication discrepancies and addressed drug therapy problems to improve medication management and reduce adverse events that may result from polypharmacy.
由药剂师主导的药物评估已被证明能改善药物管理，减少老年人多重用药的不良反应。本文定量研究了初级保健中接受治疗者的药物、药物差异和药物治疗问题。加拿大安大略省16名初级保健团队药剂师的便利样本提供了他们在过去四周内对患者进行药物评估的数据。数据通过电子数据采集表上传并完成描述性分析。研究纳入了237名患者（平均年龄67.9岁），平均服用9.2种处方药（±4.7种）。这些患者中的大多数（83.5%）被归类为多重用药患者，即每天服用至少五种或更多处方药。略多于一半的患者被归类为药物复杂性较低（52.3%）。药剂师识别出每位患者有2.1个药物差异（±3.9个）和3.6个药物治疗问题（±2.8个）。这些患者中有一半存在不止一个药物差异，几乎每位患者都被识别出有药物治疗问题。初级保健团队中的药剂师进行的药物评估减少了药物差异，并解决了药物治疗问题，以改善药物管理并减少多重用药可能导致的不良事件。
