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跨专业学生运营药物审查项目:在老年门诊进行的基于临床 STEPPS/START 的对照临床试验的临床结局。

An Interprofessional Student-Run Medication Review Program: The Clinical STOPP/START-Based Outcomes of a Controlled Clinical Trial in a Geriatric Outpatient Clinic.

机构信息

Department of Internal Medicine section Pharmacotherapy, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.

Research and Expertise Center in Pharmacotherapy Education (RECIPE), Amsterdam, The Netherlands.

出版信息

Clin Pharmacol Ther. 2022 Apr;111(4):931-938. doi: 10.1002/cpt.2475. Epub 2021 Nov 17.

Abstract

As the population ages, more people will have comorbid disorders and polypharmacy. Medication should be reviewed regularly in order to avoid adverse drug reactions and medication-related hospital visits, but this is often not done. As part of our student-run clinic project, we investigated whether an interprofessional student-run medication review program (ISP) added to standard care at a geriatric outpatient clinic leads to better prescribing. In this controlled clinical trial, patients visiting a memory outpatient clinic were allocated to standard care (control group) or standard care plus the ISP team (intervention group). The medications of all patients were reviewed by a review panel ("gold standard"), resident, and in the intervention arm also by an ISP team consisting of a group of students from the medicine and pharmacy faculties and students from the higher education school of nursing for advanced nursing practice. For both groups, the number of STOPP/START-based medication changes mentioned in general practitioner (GP) correspondence and the implementation of these changes about 6 weeks after the outpatient visit were investigated. The data of 216 patients were analyzed (control group = 100, intervention group = 116). More recommendations for STOPP/START-based medication changes were made in the GP correspondence in the intervention group than in the control group (43% vs. 24%, P = < 0.001). After 6 weeks, a significantly higher proportion of these changes were implemented in the intervention group (19% vs. 9%, P = 0.001). The ISP team, in addition to standard care, is an effective intervention for optimizing pharmacotherapy and medication safety in a geriatric outpatient clinic.

摘要

随着人口老龄化,越来越多的人将同时患有多种疾病和服用多种药物。为了避免药物不良反应和与药物相关的住院治疗,应定期审查药物,但这通常没有做到。作为我们学生管理的诊所项目的一部分,我们研究了在老年门诊中增加一个跨专业学生管理药物审查计划(ISP)是否会改善处方。在这项对照临床试验中,访问记忆门诊的患者被分配到标准护理(对照组)或标准护理加 ISP 团队(干预组)。所有患者的药物都由审查小组(“黄金标准”)、住院医师审查,在干预组中,还由一组来自医学和药学系以及高等护理学校的学生组成的 ISP 团队审查。对于这两组,研究了在全科医生(GP)通信中提到的基于 STOPP/START 的药物更改数量,以及这些更改在门诊就诊后约 6 周内的实施情况。分析了 216 名患者的数据(对照组=100 名,干预组=116 名)。在干预组的 GP 通信中提出了更多基于 STOPP/START 的药物更改建议(43%对 24%,P<0.001)。6 周后,这些更改中有更高比例在干预组中得到实施(19%对 9%,P=0.001)。除了标准护理外,ISP 团队还是优化老年门诊药物治疗和药物安全性的有效干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22e5/9299053/c63cfae4c28c/CPT-111-931-g002.jpg

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