Imperial College Healthcare NHS Trust, London, UK.
NIHR Imperial Patient Safety Translational Research Centre, Imperial College London, UK.
Int J Pharm Pract. 2021 Oct 18;29(5):458-464. doi: 10.1093/ijpp/riab050.
To explore home medicine practices and safety for people shielding and/or over the age of 70 during the COVID-19 pandemic and to create guidance, from the patient/carer perspective, for enabling safe medicine practices for this population.
Semi-structured interviews were carried out with 50 UK participants who were shielding and/or over the age of 70 and who used medicines for a long-term condition, using telephone or video conferencing. Participants were recruited through personal/professional networks and through patient/carer organisations. Participants were asked about their experiences of managing medicines during the pandemic and how this differed from previous practices. Data were analysed using inductive thematic analysis.
Patients' and their families' experiences of managing medicines safely during the pandemic varied greatly. Analysis suggests that this was based on the patient's own agency, the functioning of their medicines system pre-pandemic and their relationships with family, friends, community networks and pharmacy staff. Medicine safety issues reported included omitted doses and less-effective formulations being used. Participants also described experiencing high levels of anxiety related to obtaining medicines, monitoring medicines and feeling at risk of contracting COVID-19 while accessing healthcare services for medicine-related issues. Effects of the pandemic on medicines adherence were reported to be positive by some and negative by others.
Pharmacy staff have a key role to play by establishing good relationships with patients and their families, working with prescribers to ensure medicines systems are as joined up as possible, and signposting to community networks that can help with medicines collection.
探讨 COVID-19 大流行期间,居家隔离或 70 岁以上人群的家庭用药实践和安全性,并从患者/照护者的角度出发,为该人群制定安全用药指南。
采用电话或视频会议的方式,对 50 名正在居家隔离或 70 岁以上、长期服用药物治疗某种疾病的英国参与者进行半结构式访谈。通过个人/专业网络以及患者/照护者组织招募参与者。访谈内容包括参与者在大流行期间管理药物的经验,以及与以往做法的差异。采用归纳主题分析法对数据进行分析。
患者及其家属在大流行期间安全管理药物的经验差异很大。分析表明,这主要取决于患者自身的能动性、大流行前药物管理系统的运行情况,以及他们与家人、朋友、社区网络和药剂师的关系。报告的药物安全问题包括漏服药物和使用效果较差的药物制剂。参与者还描述了在获取药物、监测药物以及在因药物相关问题而就医时感到感染 COVID-19 的风险等方面经历了较高水平的焦虑。一些参与者报告说,大流行对药物依从性的影响是积极的,而另一些参与者则认为是消极的。
药剂师在与患者及其家属建立良好关系、与处方医生合作以确保药物系统尽可能协调一致,以及为可以帮助药物采集的社区网络提供转介方面发挥着关键作用。