Clinical Pharmacy Group, Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, P.O. Box 56, 00014, Finland.
Innovation and Development Unit, Istekki Ltd., P.O. Box 4000, FI-70601, Kuopio, Finland; Faculty of Medicine and Health Technology, Tampere University, FI-33014, Finland.
Res Social Adm Pharm. 2024 Jun;20(6):52-64. doi: 10.1016/j.sapharm.2024.01.016. Epub 2024 Feb 8.
Medication review practices have evolved internationally in a direction in which not only physicians but also other healthcare professionals conduct medication reviews according to agreed practices. Collaborative practices have increasingly highlighted the need for electronic joint platforms where information on medication regimens and their implementation can be documented, kept updated, and shared.
The aim of this study was to harmonize the definition of medication reviews and create a unified conceptual basis for their collaborative implementation and documentation in electronic patient records (definition appellation: collaborative medication review).
The study was conducted using the Delphi consensus survey with three interprofessional expert panel rounds in September-December 2020. The consensus rate was set at 80%. Experts assessed the proposed definition of collaborative medication review based on an international and national inventory of medication review definitions. The expert panel (n = 41) involved 12 physicians, 13 pharmacists, 10 nurses, and six information management professionals. The range of response rates for the rounds was 63-88%.
The experts commented on which of the pre-selected items (n = 75) characterizing medication reviews should be included in the definition of collaborative medication review. The items were divided into the following five themes and 51 of them reached consensus: 1) Actions included in the collaborative medication review (n = 24/24), 2) Settings where the review should be conducted (n = 5/5), 3) Situations where the review should be considered as needed and carried out (n = 10/11), 4) Prioritization of top five benefits to be achieved by the review and 5) Prioritization of top five patient groups to whom the review should be targeted.
A strong interprofessional consensus was reached on the definition of collaborative medication review. The most challenging was to identify individual patient groups benefiting from the review.
国际上，药物审查实践已经发展，不仅医生，而且其他医疗保健专业人员都根据既定实践进行药物审查。协作实践越来越强调需要电子联合平台，在该平台上可以记录、更新和共享药物治疗方案及其实施信息。
本研究旨在协调药物审查的定义，并为其在电子患者记录中的协作实施和记录创建统一的概念基础（定义称谓：协作药物审查）。
本研究于 2020 年 9 月至 12 月使用德尔菲共识调查进行，共进行了三轮跨专业专家小组调查。共识率设定为 80%。专家根据国际和国家药物审查定义清单评估协作药物审查的拟议定义。专家小组（n=41）由 12 名医生、13 名药剂师、10 名护士和 6 名信息管理专业人员组成。各轮的回复率范围为 63%-88%。
专家对预选自药物审查的特征（n=75）的项目进行了评论，这些项目应包含在协作药物审查的定义中。这些项目分为以下五个主题，其中 51 个项目达成共识：1）协作药物审查中包含的行动（n=24/24），2）应进行审查的环境（n=5/5），3）应考虑在需要时进行审查的情况和进行审查的情况（n=10/11），4）审查应实现的前五个最大收益的优先级，5）审查应针对的前五个受益患者群体的优先级。
跨专业专家对协作药物审查的定义达成了强烈共识。最具挑战性的是确定受益于审查的个别患者群体。
