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干预老年人正确的用药清单和用药:在护理交接期间对住院患者和居民进行的一项非随机可行性研究。

Intervention for a correct medication list and medication use in older adults: a non-randomised feasibility study among inpatients and residents during care transitions.

机构信息

Department of Biomedical Science and Biofilm - Research Center for Biointerfaces, Faculty of Health and Society, Malmö University, Malmö, Sweden.

Department of Medicine and Optometry, eHealth Institute, Linnaeus University, Kalmar, Sweden.

出版信息

Int J Clin Pharm. 2024 Jun;46(3):639-647. doi: 10.1007/s11096-024-01702-4. Epub 2024 Feb 10.

Abstract

BACKGROUND

Medication discrepancies in care transitions and medication non-adherence are problematic. Few interventions consider the entire process, from the hospital to the patient's medication use at home.

AIM

In preparation for randomised controlled trials (RCTs), this study aimed (1) to investigate the feasibility of recruitment and retention of patients, and data collection to reduce medication discrepancies at discharge and improve medication adherence, and (2) to explore the outcomes of the interventions.

METHOD

Participants were recruited from a hospital and a residential area. Hospital patients participated in a pharmacist-led intervention to establish a correct medication list upon discharge and a follow-up interview two weeks post-discharge. All participants received a person-centred adherence intervention for three to six months. Discrepancies in the medication lists, the Beliefs about Medicines Questionnaire (BMQ-S), and the Medication Adherence Report Scale (MARS-5) were assessed.

RESULTS

Of 87 asked to participate, 35 were included, and 12 completed the study. Identifying discrepancies, discussing discrepancies with physicians, and performing follow-up interviews were possible. Conducting the adherence intervention was also possible using individual health plans for medication use. Among the seven hospital patients, 24 discrepancies were found. Discharging physicians agreed that all discrepancies were errors, but only ten were corrected in the discharge information. Ten participants decreased their total BMQ-S concern scores, and seven increased their total MARS-5 scores.

CONCLUSION

Based on this study, conducting the two RCTs separately may increase the inclusion rate. Data collection was feasible. Both interventions were feasible in many aspects but need to be optimised in upcoming RCTs.

摘要

背景

在医疗过渡和药物不依从期间出现用药差异是存在问题的。很少有干预措施会考虑整个过程,从医院到患者在家中的用药情况。

目的

在准备随机对照试验(RCT)时,本研究旨在(1)调查招募和保留患者以及减少出院时用药差异和提高用药依从性的数据收集的可行性,以及(2)探索干预措施的结果。

方法

参与者从一家医院和一个住宅区招募。医院患者参与了一项由药剂师主导的干预措施,以在出院时建立正确的用药清单,并在出院后两周进行随访访谈。所有参与者都接受了为期三到六个月的以患者为中心的依从性干预。评估了用药清单、药物信念问卷(BMQ-S)和用药依从性报告量表(MARS-5)的差异。

结果

在被要求参与的 87 人中,有 35 人被纳入研究,有 12 人完成了研究。确定差异、与医生讨论差异以及进行随访访谈是可行的。使用个人用药计划来进行依从性干预也是可行的。在七名医院患者中,发现了 24 个差异。出院医生均认为所有差异都是错误的,但只有 10 个在出院信息中得到纠正。10 名参与者的总 BMQ-S 担忧评分降低,7 名参与者的总 MARS-5 评分升高。

结论

基于本研究,分别进行两项 RCT 可能会提高纳入率。数据收集是可行的。两种干预措施在许多方面都是可行的,但在即将进行的 RCT 中需要进行优化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a06/11133128/b48d3b420c98/11096_2024_1702_Fig1_HTML.jpg

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