Kimberlin C L, Berardo D H, Pendergast J F, McKenzie L C
Department of Pharmacy Health Care Administration, University of Florida, Gainesville 32610.
Med Care. 1993 May;31(5):451-68. doi: 10.1097/00005650-199305000-00007.
Community pharmacists are in a position to assume increased responsibility for preventing and resolving drug-related problems in ambulatory patients. Such an expanded role is mandated under provisions of the Omnibus Budget Reconciliation Act of 1990. The need for pharmacist oversight of drug therapy may be most acute in elderly patients. This study reports on a program to teach community pharmacists a process of assessing drug therapy of elderly patients and intervening to correct problems. Community pharmacists (N = 102) were assigned to treatment and control conditions. Both groups targeted patients meeting criteria and enrolled them into the study. Treatment group pharmacists, who participated in a training program, also assessed the medication use of enrolled patients to identify and resolve medication-related problems. Patients (N = 762) were telephoned by researchers 1 month after enrollment for an interview. Comparisons between treatment and control group patients were made on reports of pharmacist activities, knowledge of regimens, compliance, and potential drug therapy problems, such as interactions and side effects. Treatment patients were more likely to report that pharmacists provided information and assessed for problems than were control patients. These differences were maintained on 3-month follow-up questionnaires. No differences were found on the odds that patients indicated misunderstanding of regimens, non-compliance, or potential therapeutic problems.
社区药剂师有能力在预防和解决门诊患者的药物相关问题方面承担更多责任。1990年《综合预算协调法案》的条款规定了这种扩大的职责。药剂师对药物治疗进行监督的需求在老年患者中可能最为迫切。本研究报告了一个项目，该项目旨在教导社区药剂师一种评估老年患者药物治疗并进行干预以纠正问题的流程。社区药剂师（N = 102）被分配到治疗组和对照组。两组都针对符合标准的患者并将他们纳入研究。参与培训项目的治疗组药剂师还评估了已登记患者的用药情况，以识别和解决与用药相关的问题。研究人员在患者登记1个月后通过电话对患者（N = 762）进行访谈。对治疗组和对照组患者在药剂师活动报告、用药方案知识、依从性以及潜在药物治疗问题（如相互作用和副作用）方面进行了比较。与对照组患者相比，治疗组患者更有可能报告药剂师提供了信息并进行了问题评估。这些差异在3个月的随访问卷中仍然存在。在患者表示对用药方案误解、不依从或存在潜在治疗问题的几率方面未发现差异。
