评估药剂师主导的活动在澳大利亚全科医疗环境中的潜在效果：一项前瞻性观察研究。
Evaluating the potential outcomes of pharmacist-led activities in the Australian general practice setting: a prospective observational study.
机构信息
Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT, 2617, Australia.
Department of Pharmacy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, 20400, Sri Lanka.
出版信息
Int J Clin Pharm. 2023 Aug;45(4):980-988. doi: 10.1007/s11096-023-01604-x. Epub 2023 Jun 3.
BACKGROUND
Pharmacists have been co-located in general practice teams to support the quality use of medicines and optimise patient health outcomes. Evidence of the impact of pharmacist-led activities in Australian general practices is sparse.
AIM
This study aimed to evaluate the potential outcomes of pharmacist-led activities in Australian general practices.
METHOD
A prospective observational study was conducted in eight general practices in the Australian Capital Territory, where each general practice employed a pharmacist on a part-time basis for 18 months. A recommended, but flexible, list of activities was provided for pharmacists. Descriptive information on general practice pharmacist-led activities, collected with an online diary, was analysed. The potential clinical, economic, and organisational impact of pharmacist-led clinical activities was evaluated using the CLinical Economic Organisational (CLEO) tool, with a modified economic dimension.
RESULTS
Nine pharmacists reported 4290 activities over 3918.5 work hours in general practice. Medication management services were the primary clinical activity of pharmacists. In medication reviews, 75% of the pharmacists' recommendations were fully accepted by general practitioners. Conducting clinical audits, updating patients' medical records, and providing information to patients and staff were other major activities of pharmacists. Of 2419 clinical activities, around 50% had the potential for a moderate or major positive clinical impact on patients. Sixty-three per cent of activities had the potential to decrease healthcare costs. Almost all the pharmacist-led clinical activities had a positive organisational impact.
CONCLUSION
Most pharmacist-led clinical activities in general practice had the potential for a positive impact on patients and reduction in healthcare costs, supporting the expansion of this model in Australia.
背景
药剂师已在全科医疗团队中协同工作，以支持合理用药并优化患者健康结果。澳大利亚全科医疗中，药剂师主导活动的影响证据有限。
目的
本研究旨在评估澳大利亚全科医疗中由药剂师主导的活动的潜在结果。
方法
在澳大利亚首都领地的 8 家全科医疗中心进行了一项前瞻性观察性研究，每家全科医疗中心都聘请了一名兼职药剂师，为期 18 个月。为药剂师提供了一份建议但灵活的活动清单。使用在线日记收集全科医疗中由药剂师主导的活动的描述性信息，并进行分析。使用 CLinical Economic Organisational（CLEO）工具（具有修改后的经济维度）评估药剂师主导的临床活动的潜在临床、经济和组织影响。
结果
9 名药剂师在全科医疗中共报告了 4290 项活动，共计 3918.5 个工作小时。药物管理服务是药剂师的主要临床活动。在药物审查中，全科医生完全接受了药剂师 75%的建议。进行临床审计、更新患者病历以及向患者和工作人员提供信息是药剂师的其他主要活动。在 2419 项临床活动中，约有 50%具有对患者产生中度或重大积极临床影响的潜力。63%的活动有降低医疗成本的潜力。几乎所有由药剂师主导的临床活动都对组织产生了积极影响。
结论
全科医疗中大多数由药剂师主导的临床活动都有可能对患者产生积极影响并降低医疗成本，支持在澳大利亚扩展这种模式。
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