Doi Maki
Medical System Network Co., Ltd.
Kitasato University School of Pharmacy, Graduate School of Pharmaceutical Science.
Yakugaku Zasshi. 2023;143(4):337-342. doi: 10.1248/yakushi.22-00158.
In recent years, the number of patients undergoing outpatient cancer treatment has been increasing. Community pharmacies, have been increasingly involved in cancer treatment and home palliative care. However, there are several hurdles to overcome, such as logistical support during non-standard working hours (at night or during holidays), emergency visits, and for aseptic dispensing. In this paper, we describe a model of medical coordination for emergency home visits during non-standard working hours in which opioid injections need to be dispensed. The study was conducted using a mixed methods approach. We investigated the need for a medical coordination model in home palliative care as well as the issues that need to be improved upon. We constructed, implemented, and assessed the effectiveness of our medical coordination model in a research setting. The medical coordination model reduced the sense of difficulty for general practitioners and community pharmacists in dealing with patients during non-standard working hours and strengthened the degree of cooperation within the coordination team. The activities of the collaborative team saved patients from emergency hospitalization and enabled them to receive end-of-life care at home in accordance with their wishes. The basic framework of the medical coordination model can be adapted according to regional needs and will help promote home palliative care in the future.
近年来，接受门诊癌症治疗的患者数量一直在增加。社区药房越来越多地参与到癌症治疗和家庭姑息治疗中。然而，仍有几个障碍需要克服，比如非标准工作时间（夜间或节假日）的后勤支持、急诊以及无菌配药。在本文中，我们描述了一种在非标准工作时间进行紧急家访的医疗协调模式，在此期间需要进行阿片类药物注射配药。该研究采用了混合方法。我们调查了家庭姑息治疗中对医疗协调模式的需求以及需要改进的问题。我们在研究环境中构建、实施并评估了我们的医疗协调模式的有效性。该医疗协调模式降低了全科医生和社区药剂师在非标准工作时间处理患者时的困难感，并加强了协调团队内部的合作程度。协作团队的活动使患者避免了紧急住院，并使他们能够按照自己的意愿在家中接受临终关怀。该医疗协调模式的基本框架可根据地区需求进行调整，并将有助于在未来促进家庭姑息治疗。
