Jin Ran, Liu Caiyan, Chen Jinghao, Cui Mengjiao, Xu Bo, Yuan Ping, Chen Lu
School of Nursing, Nanjing Medical University, Nanjing, China.
School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.
Front Pharmacol. 2024 Sep 13;15:1426777. doi: 10.3389/fphar.2024.1426777. eCollection 2024.
Polypharmacy presents many challenges to patient medication self-management. This study aims to explore the self-management processes of medication in polypharmacy from the perspectives of both patients and healthcare providers, which can help identify barriers and facilitators to effective management. A systematic review of qualitative studies was performed by searching seven databases: PubMed, Web of Science, Cochrane Library, Embase, CINAHL, PsycINFO, and MEDLINE, from their establishment until August 2024. The Critical Appraisal Skills Programme (CASP) tool was employed to evaluate the quality of the studies included. The extracted data were then analysed thematically and integrated into The Taxonomy of Everyday Self-management Strategies (TEDSS) framework. A total of 16 studies were included, involving 403 patients and 119 healthcare providers. Patient management measures were mapped into TEDSS framework, including categories such as medical management, support-oriented domains, and emotional and role management. Enhancing patients' proactive health awareness, improving medication literacy, balancing lifestyle adjustments with medication therapy, dynamically reviewing and optimizing medications, strengthening patients' social support networks, and helping patients integrate medication management into their daily life are the key elements that can effectively assist patients in self-managing their medications. Future interventions to improve patient medication self-management ability should be designed for these issues. https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024524742.
多重用药给患者的药物自我管理带来了诸多挑战。本研究旨在从患者和医疗服务提供者的角度探索多重用药情况下的药物自我管理过程，这有助于识别有效管理的障碍和促进因素。通过检索七个数据库进行了定性研究的系统综述，这七个数据库分别是：PubMed、科学网、考克兰图书馆、Embase、护理学与健康领域数据库、心理学文摘数据库和医学期刊数据库，检索时间从各数据库建立至2024年8月。采用批判性评估技能计划（CASP）工具评估纳入研究的质量。然后对提取的数据进行主题分析，并整合到日常自我管理策略分类法（TEDSS）框架中。共纳入16项研究，涉及403名患者和119名医疗服务提供者。患者管理措施被映射到TEDSS框架中，包括医疗管理、支持导向领域以及情绪和角色管理等类别。增强患者的主动健康意识、提高用药知识水平、平衡生活方式调整与药物治疗、动态审查和优化药物、加强患者的社会支持网络以及帮助患者将药物管理融入日常生活，是能够有效协助患者进行药物自我管理的关键要素。未来改善患者药物自我管理能力的干预措施应针对这些问题进行设计。https://www.crd.york.ac.uk/PROSPERO/，标识符CRD42024524742 。
