临床专业知识、宣传与增强自主性——药剂师协助的药物审查干预措施对居住在社区的毛利族老年人的可接受性。
Clinical expertise, advocacy and enhanced autonomy - Acceptability of a pharmacist-facilitated medicines review intervention for community-dwelling Māori older adults.
作者信息
Hikaka Joanna, Jones Rhys, Hughes Carmel, Amende Hunter, Connolly Martin J, Martini Nataly
机构信息
School of Pharmacy, University of Auckland, New Zealand.
Waitematā District Health Board, Auckland, New Zealand.
出版信息
Explor Res Clin Soc Pharm. 2021 Apr 18;2:100010. doi: 10.1016/j.rcsop.2021.100010. eCollection 2021 Jun.
BACKGROUND
Pharmacist-facilitated medicines reviews are effective at identifying medicines-related problems and can improve the appropriate use of medicines in older adults. Current services in Aotearoa New Zealand (NZ) are not developed specifically for Māori (Indigenous people of NZ) and may increase health disparities between Māori and non-Māori. We developed a medicines review intervention for and with Māori older adults, and tested it in a feasibility study.
OBJECTIVE
To assess patient acceptability of a pharmacist-facilitated medicines review intervention for Māori older adults.
METHODS
The intervention consisted of a medicines education session (pharmacist and participant) and an optional medicines optimisation session (pharmacist, participant, and prescriber). Participant acceptability was assessed post-intervention using a structured telephone interview developed specifically for this study. Participants responded to statements using a five-point Likert scale (strongly agree-strongly disagree; numerical analysis/reporting) which focused on the topics of power/control, support mechanisms, intervention content and delivery, and perceived usefulness. Open-ended questions relating to the intervention value and suggestions for improvement were analysed using general inductive analysis.
RESULTS
Seventeen participants took part in the feasibility study from December 2019-March 2020 and all completed the acceptability interview. Participants perceived the intervention content and mode of delivery to be appropriate, and that their power and control over their medicines and health improved and as did their confidence in self-management. Five themes were generated: medicines knowledge from a trusted professional, increased advocacy, 'by Māori, for Māori', increased confidence and control, and financial and resource implications.
CONCLUSION
A pharmacist-facilitated medicines review intervention for Māori older adults developed by Māori, for Māori, was acceptable to patient participants. Participants valued the clinical expertise and advocacy provided by the pharmacist, and the increase in medicines knowledge, control and autonomy. Participants wanted the service to continue on an ongoing basis.
背景
由药剂师协助进行的药物审查在识别与药物相关的问题方面很有效，并且可以改善老年人对药物的合理使用。新西兰（NZ）目前的服务并非专门为毛利人（新西兰的原住民）开发，可能会加剧毛利人和非毛利人之间的健康差距。我们为毛利老年人开发并与他们共同参与了一项药物审查干预措施，并在一项可行性研究中对其进行了测试。
目的
评估由药剂师协助的针对毛利老年人的药物审查干预措施对患者的可接受性。
方法
该干预措施包括一次药物教育课程（药剂师和参与者）以及一次可选的药物优化课程（药剂师、参与者和开处方者）。干预后，使用专门为此研究开发的结构化电话访谈来评估参与者的可接受性。参与者使用五点李克特量表（从强烈同意到强烈不同意；进行数值分析/报告）对陈述做出回应，这些陈述聚焦于权力/控制、支持机制、干预内容与实施方式以及感知有用性等主题。使用一般归纳分析方法分析与干预价值和改进建议相关的开放式问题。
结果
2019年12月至2020年3月期间，17名参与者参与了可行性研究，且全部完成了可接受性访谈。参与者认为干预内容和实施方式是合适的，并且他们对药物和健康的掌控力以及自我管理的信心都有所提高。产生了五个主题：来自可信赖专业人员的药物知识、增强的支持、“毛利人主导，为毛利人服务”、增强的信心和掌控力以及财务和资源影响。
结论
由毛利人开发并为毛利老年人设计的、由药剂师协助的药物审查干预措施为患者参与者所接受。参与者重视药剂师提供的临床专业知识和支持，以及药物知识、掌控力和自主性的增加。参与者希望该服务能够持续开展。
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