处理多重用药问题 - 一项采用焦点小组访谈法对老年患者、其亲属和医疗保健专业人员进行的定性研究。
Handling polypharmacy -a qualitative study using focus group interviews with older patients, their relatives, and healthcare professionals.
机构信息
Emergency Department, Hospital Sønderjylland, Aabenraa, Denmark.
Research Unit of Emergency Medicine, Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
出版信息
BMC Geriatr. 2023 Aug 8;23(1):477. doi: 10.1186/s12877-023-04131-6.
BACKGROUND
On average, older patients use five or more medications daily. A consequence is an increased risk of adverse drug reactions, interactions, or medication errors. Therefore, it is important to understand the challenges experienced by the patients, relatives, and healthcare professionals pertinent to the concomitant use of many drugs.
METHODS
We conducted a qualitative study using focus group interviews to collect information from patients, relatives, and healthcare professionals regarding older patients' management of prescribed medicine. We interviewed seven patients using five or more medications daily, three relatives, three general practitioners, nine nurses from different healthcare sectors, one home care assistant, two hospital physicians, and four pharmacists.
RESULTS
The following themes were identified: (1) Unintentional non-adherence, (2) Intentional non-adherence, (3) Generic substitution, (4) Medication lists, (5) Timing and medication schedule, (6) Medication reviews and (7) Dose dispensing/pill organizers.
CONCLUSION
Medication is the subject of concern among patients and relatives. They become confused and insecure about information from different actors and the package leaflets. Therefore, patients often request a thorough medication review to provide an overview, knowledge of possible side effects and interactions, and a clarification of the medication's timing. In addition, patients, relatives and nurses all request an indication of when medicine should be taken, including allowable deviations from this timing. Therefore, prescribing physicians should prioritize communicating information regarding these matters when prescribing.
背景
平均而言，老年患者每天使用五或更多种药物。其结果是增加了不良反应、药物相互作用或用药错误的风险。因此，了解患者、家属和医疗保健专业人员在同时使用多种药物方面遇到的挑战非常重要。
方法
我们进行了一项定性研究，使用焦点小组访谈收集了患者、家属和医疗保健专业人员关于老年患者管理处方药物的信息。我们对每天使用五种或更多药物的七名患者、三名家属、三名全科医生、来自不同医疗保健部门的九名护士、一名家庭护理助理、两名医院医生和四名药剂师进行了访谈。
结果
确定了以下主题：（1）非故意不遵守，（2）故意不遵守，（3）通用替代，（4）用药清单，（5）时间和用药时间表，（6）药物审查和（7）剂量分配/药丸组织者。
结论
药物是患者和家属关注的问题。他们对来自不同角色和药品说明书的信息感到困惑和不放心。因此，患者通常要求进行彻底的药物审查，以提供概述、了解可能的副作用和相互作用，以及澄清药物的时间安排。此外，患者、家属和护士都要求指示何时服用药物，包括允许偏离此时间安排的情况。因此，开处方的医生应该优先在开处方时传达这些方面的信息。
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