Donati Monia, Giunchi Valentina, Grillini Giulia, Domenicali Marco, Lunardelli Maria Lia, Pasini Veronica, Milandri Susy, Mussoni Monica, Pieraccini Fabio, Sangiorgi Elisa, Raschi Emanuel, Colonnello Valentina, Lunghi Carlotta, Poluzzi Elisabetta
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Geriatric Acute Care, Orthogeriatric Unit & Center for Diagnosis of Cognitive Disorders and Dementia, IRCCS-AOUBO, Bologna, Italy.
Eur J Clin Pharmacol. 2025 May 31. doi: 10.1007/s00228-025-03852-4.
Potentially inappropriate prescriptions are associated with an increased risk of drug-drug interactions, adverse events, and unfavorable clinical outcomes, especially in older adults. Although different tools to improve appropriate prescribing have been developed to support healthcare professionals, their application and the barriers to their use remain insufficiently explored. This study aimed to assess Italian healthcare professionals' knowledge of these tools and identify obstacles to their adoption.
The study used a purposefully designed questionnaire to assess knowledge, adoption, and barriers related to appropriateness tools. The tools included were identified through a literature review and subsequently refined via expert consensus. Open-ended responses were analyzed using a conventional content analysis approach, and the analyses focused on differences across professional groups.
The survey collected 657 responses from pharmacists (35%), nurses (26%), general practitioners (22%), geriatricians/internists (9%), and other physicians (8%). The Beers and STOPP/START criteria were used by 38% and 34% of participants, respectively, with geriatricians and other physicians being the primary users. Additionally, 34% of participants reported using specific software integrated into their institutional computer systems. Among 294 respondents identifying barriers to appropriate prescribing, the most common were lack of time (14%), lack of knowledge (10%), and accessibility/costs of digital tools (8%). Key facilitators included specific training (38%), integrated software/apps (29%), and more time with patients (11%).
The adoption of tools supporting appropriate prescribing remains limited among healthcare professionals in Italy, with significant differences among professionals. Policymakers and healthcare institutions should focus on education, interprofessional collaboration, and user-friendly digital solutions to improve prescribing process and patient safety.
潜在不适当处方与药物相互作用、不良事件及不良临床结局风险增加相关，尤其是在老年人中。尽管已开发出不同工具以促进合理用药，为医疗保健专业人员提供支持，但其应用及使用障碍仍未得到充分探索。本研究旨在评估意大利医疗保健专业人员对这些工具的了解情况，并确定采用这些工具的障碍。
本研究使用专门设计的问卷来评估与合理用药工具相关的知识、采用情况及障碍。通过文献综述确定所纳入的工具，随后经专家共识进行完善。采用传统内容分析法对开放式回答进行分析，分析重点为不同专业群体之间的差异。
该调查共收集到657份回复，来自药剂师（35%）、护士（26%）、全科医生（22%）、老年病科医生/内科医生（9%）及其他医生（8%）。分别有38%和34%的参与者使用了Beers标准和STOPP/START标准，主要使用者为老年病科医生和其他医生。此外，34%的参与者报告使用了集成在其机构计算机系统中的特定软件。在294名指出合理用药障碍的受访者中，最常见的障碍是时间不足（14%）、知识缺乏（10%）以及数字工具的可及性/成本（8%）。关键促进因素包括特定培训（38%）、集成软件/应用程序（29%）以及与患者相处时间增加（11%）。
在意大利，医疗保健专业人员对支持合理用药工具的采用仍然有限，不同专业人员之间存在显著差异。政策制定者和医疗机构应关注教育、跨专业协作以及用户友好的数字解决方案，以改善用药过程和患者安全。
