横断面研究评估新的护理模式下患者的药物管理情况：在社区专科姑息治疗远程医疗服务中加入药剂师。
Cross-sectional study to evaluate patients' medication management with a new model of care: incorporating a pharmacist into a community specialist palliative care telehealth service.
机构信息
Gold Coast Supportive and Specialist Palliative Care Service, Gold Coast Hospital and Health Service, Southport, QLD, 4222, Australia.
Allied Health Research, Gold Coast Hospital and Health Service, Southport, QLD, 4215, Australia.
出版信息
BMC Palliat Care. 2024 Jul 16;23(1):172. doi: 10.1186/s12904-024-01508-1.
BACKGROUND
Patients receiving palliative care are often on complex medication regimes to manage their symptoms and comorbidities and at high risk of medication-related problems. The aim of this cross-sectional study was to evaluate the involvement of a pharmacist to an existing community specialist palliative care telehealth service on patients' medication management.
METHOD
The specialist palliative care pharmacist attended two palliative care telehealth sessions per week over a six-month period (October 2020 to March 2021). Attendance was allocated based on funding received. Data collected from the medication management reviews included prevalence of polypharmacy, number of inappropriate medication according to the Screening Tool of Older Persons Prescriptions in Frail adults with limited life expectancy criteria (STOPP/FRAIL) and recommendations on deprescribing, symptom control and medication management.
RESULTS
In total 95 patients participated in the pharmaceutical telehealth service with a mean age of 75.2 years (SD 10.67). Whilst 81 (85.3%) patients had a cancer diagnosis, 14 (14.7%) had a non-cancer diagnosis. At referral, 84 (88.4%, SD 4.57) patients were taking ≥ 5 medications with 51 (53.7%, SD 5.03) taking ≥ 10 medications. According to STOPP/FRAIL criteria, 142 potentially inappropriate medications were taken by 54 (56.8%) patients, with a mean of 2.6 (SD 1.16) inappropriate medications per person. Overall, 142 recommendations were accepted from the pharmaceutical medication management review including 49 (34.5%) related to deprescribing, 20 (14.0%) to medication-related problems, 35 (24.7%) to symptom management and 38 (26.8%) to medication administration.
CONCLUSION
This study provided evidence regarding the value of including a pharmacist in palliative care telehealth services. Input from the pharmacist resulted in improved symptom management of community palliative care patients and their overall medication management.
背景
接受姑息治疗的患者通常需要服用复杂的药物来控制症状和合并症，并且存在药物相关问题的高风险。本横断面研究的目的是评估在现有的社区专科姑息治疗远程医疗服务中加入药剂师对患者药物管理的影响。
方法
在六个月的时间里（2020 年 10 月至 2021 年 3 月），专科姑息治疗药剂师每周参加两次姑息治疗远程医疗会议。参加会议的时间是根据收到的资金分配的。从药物管理审查中收集的数据包括多药并用的流行率、根据预期寿命有限的虚弱老年人的处方筛选工具（STOPP/FRAIL）标准确定的不适当药物数量以及关于减少用药、症状控制和药物管理的建议。
结果
共有 95 名患者参加了药品远程医疗服务，平均年龄为 75.2 岁（SD 10.67）。虽然 81 名（85.3%）患者患有癌症诊断，但 14 名（14.7%）患有非癌症诊断。在转介时，84 名（88.4%，SD 4.57）患者正在服用≥5 种药物，其中 51 名（53.7%，SD 5.03）患者正在服用≥10 种药物。根据 STOPP/FRAIL 标准，54 名（56.8%）患者服用了 142 种潜在不适当的药物，每人平均有 2.6 种（SD 1.16）不适当药物。总体而言，从药物管理审查中接受了 142 项建议，其中包括 49 项（34.5%）与减少用药相关、20 项（14.0%）与药物相关问题相关、35 项（24.7%）与症状管理相关和 38 项（26.8%）与药物管理相关。
结论
本研究提供了在姑息治疗远程医疗服务中纳入药剂师的价值的证据。药剂师的投入使社区姑息治疗患者的症状管理得到改善，并且他们的整体药物管理得到改善。
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