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药师主导的老年人阿片类药物和苯二氮䓬类药物减停:实施情况与认知调查

Pharmacist-Led Deprescribing of Opioids and Benzodiazepines in Older Adults: Examining Implementation and Perceptions.

作者信息

Hughes Tamera D, Sottung Elizabeth, Nowak Juliet, Sanders Kimberly A

机构信息

Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.

出版信息

Pharmacy (Basel). 2024 Jul 30;12(4):119. doi: 10.3390/pharmacy12040119.

Abstract

This study examines the implementation and perceptions of a pharmacist consultant deprescribing program aimed at reducing the risk of falls in older adults using opioids and benzodiazepines. This qualitative study conducted interviews with healthcare providers. The interviews were conducted from August to December 2021 and analyzed using inductive coding techniques. Five participants, predominantly female MDs or PA-Cs from rural clinics, were interviewed. The participants adopted a pharmacist-led deprescribing program due to their heightened awareness of the opioid crisis, dedication to patient safety, and a desire for opioid deprescribing education. Initially, concerns included patient resistance and provider-driven barriers. However, over time, patient attitudes shifted toward greater openness to the program. The providers emphasized several critical needs for the success of the program: guaranteed access to pharmacists, tailored patient education, resources specific to providers, and financial support, including telehealth options. These factors were deemed essential to overcoming initial barriers and ensuring effective implementation. Integrating pharmacists into primary care settings shows promise for deprescribing opioids and benzodiazepines in older adults. Future research should explore telehealth options for patient-pharmacist consultations and expand the application of these findings to other healthcare settings. The study highlights the importance of awareness, patient education, access to resources (pharmacists), and provider support in addressing deprescribing among older adults.

摘要

本研究考察了一项药师咨询减药计划的实施情况及相关看法,该计划旨在降低使用阿片类药物和苯二氮䓬类药物的老年人跌倒风险。这项定性研究对医疗服务提供者进行了访谈。访谈于2021年8月至12月进行,并采用归纳编码技术进行分析。共访谈了5名参与者,主要是来自农村诊所的女性医生或助理医师。由于对阿片类药物危机的认识提高、对患者安全的执着以及对阿片类药物减药教育的需求,参与者采用了由药师主导的减药计划。最初,担忧包括患者的抵触情绪和提供者驱动的障碍。然而,随着时间的推移,患者的态度转向对该计划更加开放。提供者强调了该计划成功的几个关键需求:确保能接触到药师、量身定制的患者教育、针对提供者的特定资源以及财政支持,包括远程医疗选项。这些因素被认为对于克服初始障碍和确保有效实施至关重要。将药师纳入初级保健环境显示出在老年人中停用阿片类药物和苯二氮䓬类药物的前景。未来的研究应探索患者与药师咨询的远程医疗选项,并将这些研究结果的应用扩展到其他医疗环境。该研究强调了意识、患者教育、获取资源(药师)以及提供者支持在解决老年人减药问题中的重要性。

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A-TAPER: A Framework for Deprescribing Medications effectively.A-TAPER:一个有效减少药物剂量的框架。
Res Social Adm Pharm. 2022 Aug;18(8):3358-3361. doi: 10.1016/j.sapharm.2021.11.013. Epub 2021 Nov 30.

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