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患者使用个人健康记录进行药物重整的障碍和促进因素:一项定性研究。

Barriers and facilitators for the usage of a personal health record for medication reconciliation: A qualitative study among patients.

机构信息

Department of Clinical Pharmacy, Amphia Hospital, Breda, the Netherlands.

Department of Pharmacy, St. Maartenskliniek, Nijmegen, the Netherlands.

出版信息

Br J Clin Pharmacol. 2022 Nov;88(11):4751-4762. doi: 10.1111/bcp.15409. Epub 2022 May 31.

Abstract

AIMS

Personal health records (PHRs) are more often used for medication reconciliation (MR). However, patients' adoption rate is low. We aimed to provide insight into patients' barriers and facilitators for the usage of a PHR for MR prior to an in- or outpatient visit.

METHODS

A qualitative study was conducted among PHR users and non-users who had a planned visit at the outpatient rheumatology department or the inpatient cardiology or neurology department. About 1 week after the hospital visit, patients were interviewed about barriers and facilitators for the usage of a PHR for MR using a semi-structured interview guide based on the theoretical domains framework. Afterwards, data were analysed following thematic analysis.

RESULTS

Ten PHR users and non-users were interviewed. Barriers and facilitators were classified in four domains: patient, application, process and context. We identified 14 barriers including limited (health) literacy and/or computer skills, practical and technical issues, ambiguity about who is responsible (the patient or the healthcare provider) and lack of data exchange and connectivity between applications. Besides that, ten facilitators were identified including being place and time independent, improve usability, target patients who benefit most and/or have sufficient skills, and integration of different applications.

CONCLUSION

Barriers and facilitators identified at the patient, application, process and context level, need to be addressed to effectively develop and implement PHRs for MR.

摘要

目的

个人健康记录(PHR)越来越多地用于药物重整(MR)。然而,患者的采用率很低。我们旨在深入了解患者在门诊或住院的风湿病、心脏病学或神经病学部门就诊前,使用 PHR 进行 MR 的障碍和促进因素。

方法

在计划在门诊风湿病科或住院心脏病科或神经内科就诊的 PHR 用户和非用户中进行了一项定性研究。在医院就诊后大约 1 周,根据理论领域框架,使用半结构化访谈指南,对患者使用 PHR 进行 MR 的障碍和促进因素进行访谈。然后,根据主题分析对数据进行分析。

结果

对 10 名 PHR 用户和非用户进行了访谈。障碍和促进因素分为四个领域:患者、应用、流程和环境。我们确定了 14 个障碍,包括有限的(健康)识字和/或计算机技能、实际和技术问题、关于谁负责(患者还是医疗保健提供者)的模糊性以及应用程序之间缺乏数据交换和连接。除此之外,还确定了 10 个促进因素,包括位置和时间独立、提高可用性、针对最受益和/或具有足够技能的患者、以及整合不同的应用程序。

结论

需要解决患者、应用、流程和环境层面确定的障碍和促进因素,以有效地开发和实施用于 MR 的 PHR。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2a0/9796132/db0f8456fb97/BCP-88-4751-g003.jpg

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