Ensing Hendrik T, Kurt Nelly, Janssen Ruby A, Koster Ellen S, Heerdink Eibert R
Outpatient Pharmacy 'de Brug 24/7', Zorggroep Almere, Almere, The Netherlands.
Department of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, PO Box 80082, 3508 TB, Utrecht, The Netherlands.
Int J Clin Pharm. 2025 Apr;47(2):325-334. doi: 10.1007/s11096-024-01829-4. Epub 2024 Dec 10.
Patients transitioning from hospital to home while starting long-term cardiovascular medicines are likely to experience drug-related problems (DRPs). The New Medicine Service (NMS) may support readmission to primary care.
To evaluate NMS in a real world setting, for patients transitioning from hospital to primary care with newly prescribed cardiovascular medicines on identifying DRPs, patient satisfaction with medication information and patient self-efficacy. Secondary objectives were identifying risk factors for DRPs and assessing first-fill discontinuation.
A cohort study in an outpatient pharmacy and 14 community pharmacies in Almere, the Netherlands, involved patients ≥ 18 years receiving new cardiovascular prescriptions. Usual pharmacy care was complemented with a telephone counselling two weeks post-dispensing to identify and address DRPs. Patient satisfaction and self-efficacy were assessed during a follow-up call. First-fill discontinuation was measured using dispensing data, and logistic regression identified risk factors for DRPs.
Of 1647 eligible patients, 743 received NMS; 72.5% experienced ≥ 1 DRP. NMS improved patients' satisfaction with information and self-efficacy (p < 0.001). Outpatient visits (adj. OR 0.64), cardiovascular medicine use (adj. OR 0.65), and use of chronic medicines (adj. OR 1.71) influenced DRPs. First-fill discontinuation remained unchanged post-NMS, but patients with DRPs discontinued more often (14.8% vs. 8.6%, p = 0.030).
Implementing the NMS in a real-world transitional care setting allowed pharmacists to identify DRPs and provide counselling tailored to patient needs. Patients reported higher satisfaction with information and increased self-efficacy. Priority should be given to at-risk patients for DRPs, and deploy other pharmacy staff to perform the NMS.
开始使用长期心血管药物的患者从医院过渡到家庭时，可能会出现与药物相关的问题（DRP）。新药物服务（NMS）可能有助于重新接受初级保健。
在现实环境中评估NMS，针对从医院过渡到初级保健并新开具心血管药物的患者，识别DRP、患者对用药信息的满意度以及患者自我效能感。次要目标是识别DRP的风险因素并评估首次配药后的停药情况。
在荷兰阿尔梅勒的一家门诊药房和14家社区药房进行的一项队列研究，纳入年龄≥18岁且接受新心血管处方的患者。常规药房护理在配药两周后通过电话咨询进行补充，以识别和解决DRP。在随访电话中评估患者满意度和自我效能感。使用配药数据测量首次配药后的停药情况，并通过逻辑回归识别DRP的风险因素。
在1647名符合条件的患者中，743名接受了NMS；72.5%的患者经历了≥1次DRP。NMS提高了患者对信息的满意度和自我效能感（p<0.001）。门诊就诊（调整后比值比0.64）、心血管药物使用（调整后比值比0.65）和慢性药物使用（调整后比值比1.71）影响DRP。NMS后首次配药后的停药情况保持不变，但有DRP的患者停药更频繁（14.8%对8.6%，p=0.030）。
在现实的过渡性护理环境中实施NMS，使药剂师能够识别DRP并提供针对患者需求的咨询。患者报告对信息的满意度更高，自我效能感增强。应优先关注有DRP风险的患者，并安排其他药房工作人员开展NMS。
