Yanagisawa Yuki, Yokokawa Yuki, Kizaki Hayato, Sayama Kyoko, Yokoyama Sakura, Sasaki Tsuyoshi, Someya Mitsuhiro, Taniguchi Ryoo, Imai Shungo, Hori Satoko
Division of Drug Informatics, Keio University Faculty of Pharmacy.
Nakajima Pharmacy.
Yakugaku Zasshi. 2024;144(8):839-845. doi: 10.1248/yakushi.24-00080.
The purpose of this study was to identify patient outcomes after pharmacist interventions in the home health care context using pharmaceutical care records accumulated during daily operations. We focused on 591 cases at Nakajima Pharmacy from April 2020 to December 2021, where dispensing fees were charged to prevent duplication of medication and unnecessary interactions of home patients (excluding those related to adjustment of ongoing medications). The study investigated the content and background of prescription changes, the follow-up rate, and patient outcomes. The most common circumstances that led to pharmacist intervention for homebound patients were symptom occurrence (uncontrolled symptom, new symptom, drug adverse event). Of the patients for whom pharmacist intervention was provided for symptoms, 72.8% received follow-up according to the pharmaceutical care records. Furthermore, 59.2% of patients with follow-up showed an improvement of their symptoms. In addition, many patients had their medications discontinued or the dosage reduced by the pharmacist despite stable symptoms. More than 90% of these patients showed no change in symptoms. Besides interventions associated with the occurrence of symptoms, many interventions related to medication adherence were found to result from the patient's physical condition, such as poor swallowing function. The results suggest that tracking pharmacy drug histories may help pharmacists to better understand the need for follow-up implementation and the changes in patient outcomes after interventions.
本研究的目的是利用日常运营中积累的药学服务记录,确定在家庭医疗保健环境中,药师干预后的患者结局。我们重点关注了中岛药房在2020年4月至2021年12月期间的591例病例,这些病例收取了配药费用,以防止家庭患者重复用药和不必要的相互作用(不包括与正在使用的药物调整相关的情况)。该研究调查了处方变更的内容和背景、随访率以及患者结局。导致药师对居家患者进行干预的最常见情况是症状出现(症状未得到控制、出现新症状、药物不良事件)。在因症状接受药师干预的患者中,72.8%根据药学服务记录接受了随访。此外,接受随访的患者中有59.2%症状得到改善。此外,尽管症状稳定,但许多患者的药物被药师停用或剂量减少。这些患者中超过90%的症状没有变化。除了与症状出现相关的干预措施外,还发现许多与用药依从性相关的干预措施是由患者的身体状况引起的,如吞咽功能差。结果表明,追踪药房用药史可能有助于药师更好地理解随访实施的必要性以及干预后患者结局的变化。