Homann Katharina, Bertsche Thilo, Schiek Susanne
Department of Clinical Pharmacy, Institute of Pharmacy, Faculty of Medicine, Leipzig University, Leipzig, Germany.
Drug Safety Center, University Hospital Leipzig, Leipzig University, Leipzig, Germany.
J Multidiscip Healthc. 2021 Jan 15;14:103-114. doi: 10.2147/JMDH.S279154. eCollection 2021.
Older patients are still not sufficiently integrated into multidisciplinary care concepts including geriatric and palliative care. They do, however, regularly visit pharmacies to fill prescriptions or to buy self-medication. Thus, they have frequent contact with pharmacy technicians (PTs), who are widely involved in counselling in Germany. However, it is not known whether geriatric symptoms are recognized by PTs and to what extent older patients use their pharmacy to address geriatric or palliative concerns. This study aimed to investigate PTs' impression of older patients' symptoms, geriatric and palliative concerns in consultations, as well as multidisciplinary collaboration.
We conducted a cross-sectional study in April-May 2019. Using a self-administered questionnaire, PTs were asked about (i) geriatric symptoms, (ii) geriatric and palliative concerns older patients expressed in routine consultations, (iii) supposed reasons for inadequate care, and (iv) PTs' desire for multidisciplinary cooperation.
(i) The 5 most common symptoms the 339 participating PTs recognized in the community pharmacy were pain, insomnia, restricted mobility, eye disorders, and constipation. (ii) The three most frequently addressed non-drug-related geriatric palliative concerns were mental strain, loneliness, and mourning. (iii) As reasons for inadequate patient care, PTs predominantly mentioned patient-related reasons (299 of 518 reasons, 58%). (iv) 85% of the PTs desired closer cooperation with general practitioners, 84% with nursing services and 39% with palliative physicians.
PTs frequently saw older patients visiting the pharmacy who suffer from a variety of symptoms. PTs were additionally confronted with diverse geriatric or palliative concerns. We deduce, first, a need for PT training in geriatric and palliative care. Second, multidisciplinary care concepts and research should include pharmacies because they seem to be a low-threshold contact to older patients, who might need access to adequate care.
老年患者仍未充分融入包括老年护理和姑息治疗在内的多学科护理理念。然而，他们会定期前往药房取药或购买非处方药。因此，他们经常与药房技术人员（PTs）接触，在德国，药房技术人员广泛参与咨询服务。然而，目前尚不清楚药房技术人员是否能识别老年症状，以及老年患者在多大程度上利用药房来解决老年护理或姑息治疗方面的问题。本研究旨在调查药房技术人员对老年患者症状的印象、咨询中的老年护理和姑息治疗问题，以及多学科协作情况。
我们在2019年4月至5月进行了一项横断面研究。通过自填式问卷，询问药房技术人员以下问题：（i）老年症状；（ii）老年患者在常规咨询中表达的老年护理和姑息治疗问题；（iii）护理不足的假定原因；（iv）药房技术人员对多学科合作的期望。
（i）339名参与研究的药房技术人员在社区药房中识别出的5种最常见症状为疼痛、失眠、行动不便、眼部疾病和便秘。（ii）最常提及的与药物无关的老年姑息治疗问题是精神压力、孤独和哀伤。（iii）作为患者护理不足的原因，药房技术人员主要提到与患者相关的原因（518个原因中的299个，占58%）。（iv）85%的药房技术人员希望与全科医生加强合作，84%希望与护理服务机构合作，39%希望与姑息治疗医生合作。
药房技术人员经常见到有各种症状的老年患者前来药房。此外，药房技术人员还面临着各种老年护理或姑息治疗问题。我们推断，首先，需要对药房技术人员进行老年护理和姑息治疗方面的培训。其次，多学科护理理念和研究应纳入药房，因为药房似乎是与老年患者的低门槛接触点，而这些患者可能需要获得适当的护理。
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