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建立社区参与的多学科伙伴关系以改善患有多种慢性病的老年患者的药物管理。

Building Community-Engaged Multidisciplinary Partnerships to Improve Medication Management in Elderly Patients With Multiple Chronic Conditions.

作者信息

Poon Ivy O, Skelton Felicia, Bean Lena R, Guinn Dominique, Jemerson Terica L, Mbue Ngozi D, Charles Creaque V, Ndefo Uche Anadu

机构信息

Department of Pharmacy Practice, College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX.

Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX.

出版信息

J Patient Cent Res Rev. 2021 Apr 19;8(2):113-120. eCollection 2021 Spring.

Abstract

PURPOSE

Many studies in preventing adverse drug events have been researcher-driven, yet few have engaged patients in the development of a project. This project aims to engage minority elderly patients with multiple chronic conditions in the development of research questions and strategies to improve medication safety.

METHODS

Elderly patients (≥65 years old) who were prescribed 7 or more chronic medications were recruited through a university-based aging resource network in a historically African American community in Houston, Texas. Patients and a caregiver participated in a multidisciplinary workgroup comprised of a physician, pharmacists, a nurse, health educators, and a social worker. Patients were engaged by utilizing the 4 patient-centered outcomes research engagement principles. The workgroup created a strategic plan, completed an environmental scan, identified research problems, and reviewed current evidence-based approaches in the literature. Workgroup findings were presented to a broader audience within a community town hall setting, and input was collected from a community-wide survey.

RESULTS

From April 2018 to July 2018, 3 patients and 1 caregiver participated in 5 multidisciplinary workgroup meetings. A total of 74 seniors attended the town hall meeting, and 69 completed the surveys. The most common drug-related problems among survey participants were doubts about drug advertisements (79%) and drug interactions (70%). Most participants (88%) were more comfortable in receiving face-to-face counseling compared to an app or virtual visits. Findings aided in developing 3 grant proposals.

CONCLUSIONS

This narrative provides a roadmap for conducting multidisciplinary, patient-centered participatory research to refine research strategies in minimizing drug-related problems.

摘要

目的

许多预防药物不良事件的研究是由研究人员推动的,但很少有让患者参与项目开发的。本项目旨在让患有多种慢性病的老年少数族裔患者参与研究问题和改善用药安全策略的制定。

方法

通过德克萨斯州休斯顿一个历史上以非裔美国人为主的社区中基于大学的老龄资源网络,招募了开具7种或更多慢性药物处方的老年患者(≥65岁)。患者及其护理人员参与了一个多学科工作组,该工作组由一名医生、药剂师、护士、健康教育工作者和一名社会工作者组成。通过运用4条以患者为中心的结果研究参与原则让患者参与进来。该工作组制定了一项战略计划,完成了环境扫描,确定了研究问题,并回顾了文献中当前基于证据的方法。工作组的研究结果在社区市政厅会议上向更广泛的受众展示,并从全社区范围的调查中收集意见。

结果

2018年4月至2018年7月,3名患者和1名护理人员参加了5次多学科工作组会议。共有74名老年人参加了市政厅会议,69人完成了调查。调查参与者中最常见的与药物相关的问题是对药品广告的怀疑(79%)和药物相互作用(70%)。与应用程序或虚拟就诊相比,大多数参与者(88%)更愿意接受面对面咨询。研究结果有助于制定3项资助提案。

结论

本叙述为开展多学科、以患者为中心的参与性研究提供了路线图,以完善减少药物相关问题的研究策略。

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