Kanninen Jonna-Carita, Toivo Terhi, Airaksinen Marja, Holm Anu, Savela Eeva, Dimitrow Maarit, Tuunanen Jarkko, Leikola Saija, Puustinen Juha
Faculty of Technology Satakunta University of Applied Sciences Pori Finland.
Clinical Pharmacy Group, Division of Pharmacology and Pharmacotherapy University of Helsinki Helsinki Finland.
Health Sci Rep. 2024 Mar 12;7(3):e1971. doi: 10.1002/hsr2.1971. eCollection 2024 Mar.
Cooperation between practicing community pharmacists (PPs) and primary care physicians has traditionally been limited, with scarce communication on therapeutic issues. The aim of this study was to assess how PPs communicate in writing with physicians regarding (1) the clinically relevant problems they have identified in patients' medications and (2) recommendations to solve the problems to identify development needs in the communication process.
This retrospective validation study assessed medication reviews conducted by PPs in collaboration with home care nurses, practice nurses, and physicians for 46 older (≥65 years) home care clients in the Municipality of Lohja, Finland. The therapeutic and communicative appropriateness of clinically relevant drug-related problems (DRPs) identified by PPs and reported in writing to physicians was blindly evaluated by (1) an accredited pharmacist (AP) and (2) two physicians specialized in geriatric pharmacotherapy. Descriptive statistical analysis was conducted to compare the assessments.
The PPs ( = 13) identified 189 DRPs and made 4.1 recommendations per patient in 46 written reports to physicians. Of the PPs' written recommendations for medication changes, 46% (155/334) were the same as those by the AP. The two specialized physicians evaluated 69% and 67% of PPs' recommendations to be clinically relevant. The way the DRPs and recommendations to solve them were communicated was evaluated as appropriate in 38% and 38%, respectively, of the case reports written by the PPs.
The PPs were able identify DRPs quite well, particularly inappropriate medication use, according to current care guidelines and formularies. It was found that improvement was needed in the communication of DRPs in written reports with physicians. Interprofessional learning by working in care teams would be suitable for strengthening patient care-oriented competencies.
社区执业药师（PPs）与初级保健医生之间的合作传统上较为有限，在治疗问题上的沟通很少。本研究的目的是评估PPs如何就以下方面与医生进行书面沟通：（1）他们在患者用药中发现的临床相关问题；（2）解决这些问题的建议，以确定沟通流程中的发展需求。
这项回顾性验证研究评估了芬兰洛哈市46名老年（≥65岁）家庭护理客户的PPs与家庭护理护士、执业护士和医生合作进行的用药审查。由一名认可药剂师（AP）和两名老年药物治疗专家对PPs识别出并书面报告给医生的临床相关药物相关问题（DRPs）的治疗和沟通适宜性进行盲法评估。进行描述性统计分析以比较评估结果。
13名PPs在给医生的46份书面报告中识别出189个DRPs，每位患者提出4.1条建议。在PPs关于药物变更的书面建议中，46%（155/334）与AP的建议相同。两名专家医生分别评估了PPs 69%和67%的建议具有临床相关性。在PPs撰写的病例报告中，分别有38%的DRPs和解决这些问题的建议的沟通方式被评估为适宜。
根据当前的护理指南和处方集，PPs能够很好地识别DRPs，尤其是不适当的药物使用。研究发现，与医生的书面报告中DRPs的沟通需要改进。通过在护理团队中工作进行跨专业学习将适合加强以患者护理为导向的能力。
