Oonk Nicol G M, Dorresteijn Lucille D A, Te Braake Eline, Movig Kris L L, van der Palen Job, Nijmeijer Henk-Willem, van Kesteren Mirjam E, Bode Christina
Department of Neurology, Medisch Spectrum Twente, PO Box 50000, Enschede 7500 KA, The Netherlands.
Department of Behavioural, Management and Social Sciences, University of Twente, Enschede, The Netherlands.
Ther Adv Drug Saf. 2024 Apr 30;15:20420986241237071. doi: 10.1177/20420986241237071. eCollection 2024.
Executing structured medication reviews (SMRs) in primary care to optimize drug treatment is considered standard care of community pharmacists in the Netherlands. Patients with Parkinson's disease (PD) often face complex drug regimens for their symptomatic treatment and might, therefore, benefit from an SMR. However, previously, no effect of an SMR on quality of life in PD was found. In trying to improve the case management of PD, it is interesting to understand if and to what extent SMRs in PD patients are of added value in the pharmacist's opinion and what are assumed facilitating and hindering factors.
To analyse the process of executing SMRs in PD patients from a community pharmacist's point of view.
A cross-sectional, qualitative study was performed, consisting of face-to-face semi-structured in-depth interviews.
The interviews were conducted with community pharmacists who executed at least one SMR in PD, till data saturation was reached. Interviews were transcribed verbatim, coded and analysed thematically using an iterative approach.
Thirteen pharmacists were interviewed. SMRs in PD were considered of added value, especially regarding patient contact and bonding, individualized care and its possible effect in the future, although PD treatment is found already well monitored in secondary care. Major constraints were time, logistics and collaboration with medical specialists.
Although community pharmacist-led SMRs are time-consuming and sometimes logistically challenging, they are of added value in primary care in general, and also in PD, of which treatment occurs mainly in secondary care. It emphasizes the pharmacist's role in PD treatment and might tackle future drug-related issues. Improvements concern multidisciplinary collaboration for optimized SMR execution and results.
在初级保健中开展结构化药物审查（SMR）以优化药物治疗被认为是荷兰社区药剂师的标准护理工作。帕金森病（PD）患者在对症治疗时往往面临复杂的药物治疗方案，因此可能受益于结构化药物审查。然而，此前未发现结构化药物审查对帕金森病患者生活质量有影响。在试图改善帕金森病的病例管理时，了解在药剂师看来帕金森病患者的结构化药物审查是否具有附加价值以及在何种程度上具有附加价值，以及假定的促进因素和阻碍因素是什么，是很有意思的。
从社区药剂师的角度分析对帕金森病患者执行结构化药物审查的过程。
进行了一项横断面定性研究，包括面对面的半结构化深入访谈。
对至少对一名帕金森病患者进行过一次结构化药物审查的社区药剂师进行访谈，直至达到数据饱和。访谈内容逐字转录，编码并采用迭代方法进行主题分析。
采访了13名药剂师。帕金森病的结构化药物审查被认为具有附加价值，特别是在患者接触与联系、个性化护理及其未来可能产生的影响方面，尽管发现在二级护理中帕金森病治疗已得到良好监测。主要限制因素是时间、后勤以及与医学专家的协作。
尽管由社区药剂师主导的结构化药物审查耗时且有时在后勤方面具有挑战性，但总体而言，它们在初级保健中具有附加价值，在帕金森病护理中也是如此，而帕金森病治疗主要在二级护理中进行。这强调了药剂师在帕金森病治疗中的作用，并可能解决未来与药物相关的问题。改进措施涉及多学科协作以优化结构化药物审查的执行和结果。
