一项系统评价研究考察了 NHS 患者药品咨询热线服务使用者的特征，以及他们提出的咨询类型。
A systematic review examining the characteristics of users of NHS patient medicines helpline services, and the types of enquiries they make.
机构信息
Department of Pharmacy and Pharmacology, University of Bath, Bath, UK.
Department of Psychology, University of Bath, Bath, UK.
出版信息
Eur J Hosp Pharm. 2020 Nov;27(6):323-329. doi: 10.1136/ejhpharm-2019-002001. Epub 2019 Oct 31.
BACKGROUND AND OBJECTIVE
Patient medicines helpline services (PMHS) are available from some National Health Service Trusts in the UK to support patients following their discharge from hospital. The aim of this systematic review was to examine the available evidence regarding the characteristics of enquirers and enquiries to PMHS, in order to develop recommendations for service improvement.
METHODS
Searches were conducted using Medline, Embase, Cumulative Index of Nursing and Allied Health Literature, Scopus, and Web of Science, on 4 June 2019. Forward and backward citation searches were conducted, and grey literature was searched. Studies were included if they reported any characteristics of enquirers who use PMHS, and/or enquiries received. Study quality was assessed using the Axis tool. A narrative synthesis was conducted, and where appropriate, weighted means (WMs) were calculated. Where possible, outcomes were compared with Hospital Episode Statistics (HES) data for England, to establish whether the profile of helpline users may differ to that of hospital patients.
RESULTS
Nineteen studies were included (~4362 enquiries). Risk of bias from assessed studies was 71%. Enquirers were predominantly female (WM=53%; HES mean=57%), elderly (WM=69 years; HES mean=53 years) and enquired regarding themselves (WM=72%). Out of inpatient and outpatient enquirers, 50% were inpatients and 50% were outpatients (WM). Six of 15 studies reported adverse effects as the main enquiry reason. Two of four studies reported antimicrobial drugs as the main enquiry drug class. From two studies, the main clinical origin of enquiries were general surgery and cardiology. Across six studies, 27% (WM) of enquiries concerned medicines-related errors.
CONCLUSIONS
Our findings show that PMHS are often used by elderly patients, which is important since this group may be particularly vulnerable to experiencing medicines-related issues following hospital discharge. Over a quarter of enquiries to PMHS may concern medicines-related errors, suggesting that addressing such errors is an important function of this service. However, our study findings may be limited by a high risk of bias within included studies. Further research could provide a more detailed profile of helpline users (eg, ethnicity, average number of medicines consumed), and we encourage helpline providers to use their enquiry data to conduct local projects to improve hospital services (eg, reducing errors).
PROSPERO REGISTRATION NUMBER
CRD42018116276.
背景与目的
英国一些国民保健服务信托基金会提供患者用药咨询热线服务（PMHS），以支持患者出院后的用药需求。本系统评价旨在考察 PMHS 来电者特征和咨询内容的现有证据，以便为服务改进提供建议。
方法
于 2019 年 6 月 4 日，通过 Medline、Embase、护理学和联合健康文献累积索引、Scopus 和 Web of Science 进行了检索。进行了向前和向后引文检索，并搜索了灰色文献。如果研究报告了使用 PMHS 的来电者的任何特征，以及/或接收到的咨询，那么将其纳入研究。使用 Axis 工具评估了研究质量。进行了叙述性综合分析，并在适当的情况下计算了加权平均值（WM）。在可能的情况下，将结果与英格兰的医院入院统计数据（HES）进行比较，以确定咨询热线用户的情况是否与医院患者的情况不同。
结果
纳入了 19 项研究（~4362 次咨询）。评估研究的偏倚风险为 71%。来电者主要为女性（WM=53%；HES 平均值=57%），年龄较大（WM=69 岁；HES 平均值=53 岁），且主要咨询自身情况（WM=72%）。在住院和门诊来电者中，50%为住院患者，50%为门诊患者（WM）。6 项研究中有 15 项报告了不良影响为主要咨询原因。4 项研究中有 2 项报告了抗菌药物为主要咨询药物类别。有两项研究报告称，咨询的主要临床来源为普通外科和心脏病学。6 项研究中有 27%（WM）的咨询与药物相关错误有关。
结论
我们的研究结果表明，PMHS 经常被老年患者使用，这一点很重要，因为该人群在出院后可能特别容易出现与药物相关的问题。向 PMHS 提出的咨询中，有四分之一以上可能与药物相关错误有关，这表明解决此类错误是该服务的一项重要功能。然而，我们的研究结果可能受到纳入研究中偏倚风险高的限制。进一步的研究可以提供更详细的咨询热线用户概况（例如，种族、平均用药数量），我们鼓励咨询热线服务提供商利用其咨询数据开展改善医院服务的本地项目（例如，减少错误）。
PROSPERO 注册号：CRD42018116276。
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