Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, Universityof Manchester, Stopford Building, Oxford Road, Manchester, M13 9PT, United Kingdom; King Abdulaziz Medical City, Pharmaceutical Care Services, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, Universityof Manchester, Stopford Building, Oxford Road, Manchester, M13 9PT, United Kingdom.
Res Social Adm Pharm. 2021 Nov;17(11):1907-1922. doi: 10.1016/j.sapharm.2021.02.009. Epub 2021 Feb 14.
Hospital pharmacists play an essential role in patient care; however, a lack of resources means pharmacists are unable to review all patients daily. Consequently, there is a demand for reliable screening tools to allocate care to patients with urgent and/or complex pharmaceutical needs. Several tools have been developed, but no broad consensus exists on the design of a screening tool to be used in the adult hospital setting.
To obtain expert consensus on the design of a pharmaceutical care complexity screening tool for use on admission to hospital.
Two Delphi studies were conducted: the first sought to gain consensus from experts including pharmacists, academics and physicians on the components of a pharmaceutical complexity tool, the second to achieve consensus from UK chief pharmacists and clinical service pharmacy managers on the clinical appropriateness and practicality of the tool. Tool components and Delphi statements were identified and refined from our previous systematic review, UK survey and interview study of prioritisation tools. A valid definition for consensus was used.
Over 300 components were extracted from the interview data and systematic review and then refined for inclusion in the first Delphi study. Thirty-three experts completed Delphi One and consensus was reached on 92 components. Components were grouped into demographic, clinical and medication components and condensed to 33 items, which were included in the first draft of the Adult Complexity Tool for Pharmaceutical Care (ACTPC). The tool stratified patients into highly, moderately or least complex. Forty expert panellists completed Delphi Two and consensus was reached on review frequency and experience of pharmacy practitioner at each level. These decisions were incorporated into the final version of the ACTPC.
The ACTPC is the first systematically designed and internationally agreed tool for use on medical admission to hospital. It has potential to enable the delivery of targeted patient-centred pharmaceutical care.
医院药师在患者护理中发挥着重要作用；然而，由于资源匮乏，药师无法每天对所有患者进行审查。因此，需要有可靠的筛选工具来为有紧急和/或复杂药物需求的患者分配护理。已经开发了几种工具，但对于在成人医院环境中使用的筛选工具的设计尚未达成广泛共识。
就用于入院时的药物治疗复杂性筛选工具的设计达成专家共识。
进行了两项德尔菲研究：第一项研究旨在使包括药剂师、学者和医生在内的专家就药物复杂性工具的组成部分达成共识；第二项研究旨在使英国首席药剂师和临床服务药剂经理就工具的临床适宜性和实用性达成共识。工具组件和德尔菲声明是从我们之前的系统评价、英国调查和优先排序工具访谈研究中确定和完善的。使用了有效的共识定义。
从访谈数据和系统评价中提取了 300 多个组件，然后进行了精炼，以纳入第一项德尔菲研究。33 名专家完成了德尔菲研究 1，达成了 92 个组件的共识。组件被分为人口统计学、临床和药物成分，并被压缩到 33 个项目，这些项目被纳入成人药物治疗复杂性工具（ACTPC）的初稿。该工具将患者分为高度、中度或低度复杂。40 名专家小组成员完成了德尔菲研究 2，并就每个级别药物师的审查频率和经验达成共识。这些决策被纳入 ACTPC 的最终版本。
ACTPC 是第一个为入院患者设计的系统和国际认可的工具。它有可能实现以患者为中心的药物治疗目标。
