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“你宁愿不让自己的身体塞满药丸”——患者对综合医疗中多药合用及药剂师药物评估的看法

'You would rather not fill your body with pills'-patient perspectives on polypharmacy and medication reviews by pharmacists in general practice.

作者信息

Als Josefine Graabæk, Thomsen Janus Laust, Sørensen Sabrina Storgaard, Johnsen Søren Paaske, Merrild Camilla Hoffmann

机构信息

Center for General Practice, Aalborg University, Aalborg, Denmark.

Danish Center for Health Service Research, Aalborg University, Aalborg, Denmark.

出版信息

Scand J Prim Health Care. 2025 Jun;43(2):411-421. doi: 10.1080/02813432.2025.2451660. Epub 2025 Jan 13.

Abstract

INTRODUCTION

Polypharmacy is widespread. The demographic shift toward older patients receiving multiple medications increases risk and drug-related problems in these patients.

OBJECTIVE

To investigate patient perspectives on polypharmacy and the experienced effects of medication reviews by pharmacists in general practice.

METHODS

Twenty-two semi-structured interviews with patients with polypharmacy (>5 medications) from 6 different general practice clinics in the North Denmark region. The interviewees were from the intervention arm of a randomized clinical trial and had received a medication review with a pharmacist in addition to the usual annual check-up in general practice. Participants were interviewed at baseline (no later than 2 weeks after the medication review) and again at follow-up (6 months after the medication review). The interviews were transcribed verbatim and thematically analyzed with an inductive approach.

RESULTS

The patients' narratives show that they face many difficulties in their everyday lives, making it hard for them to live up to society's ideal of what it is to live a healthy life. The interviewees were generally positive toward the intervention and felt comfortable having a pharmacist conduct the medication review in their usual general practice clinic. Some interviewees gained more insight into their medication from the review.

CONCLUSION

Patient narratives give a comprehensive understanding of the challenges of polypharmacy. Having pharmacists conduct medication reviews in general practice could ensure more time and focus on patients and their medication management. The combined knowledge of physicians, nurses, and pharmacists regarding thorough polypharmacy management is recommended.

摘要

引言

多重用药现象普遍存在。人口结构向老年患者使用多种药物的转变增加了这些患者的风险及与药物相关的问题。

目的

调查患者对多重用药的看法以及药剂师在全科医疗中进行用药评估的实际效果。

方法

对丹麦北部地区6家不同全科医疗诊所中使用多种药物(>5种药物)的患者进行了22次半结构化访谈。受访者来自一项随机临床试验的干预组,除了在全科医疗中进行常规年度检查外,还接受了药剂师的用药评估。在基线时(用药评估后不迟于2周)和随访时(用药评估后6个月)对参与者进行访谈。访谈内容逐字记录,并采用归纳法进行主题分析。

结果

患者的叙述表明,他们在日常生活中面临许多困难,难以达到社会对健康生活的理想标准。受访者总体上对干预措施持积极态度,并且对药剂师在其常规全科医疗诊所进行用药评估感到安心。一些受访者从评估中对自己的用药有了更多了解。

结论

患者叙述能全面理解多重用药的挑战。让药剂师在全科医疗中进行用药评估可以确保有更多时间并专注于患者及其用药管理。建议医生、护士和药剂师就全面的多重用药管理联合开展知识普及工作。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a273/12090281/7c2f1e901a29/IPRI_A_2451660_F0001_C.jpg

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