Schmidt I K, Claesson C B, Westerholm B, Nilsson L G
National Board of Health and Welfare, Stockholm.
Ann Pharmacother. 1998 Jan;32(1):27-32. doi: 10.1177/106002809803200102.
To describe the type and frequency of drug-related problems discussed in regular team meetings conducted in 15 Swedish nursing homes and report physician and staff assessments of these interventions and residents' outcomes.
The data were collected within the context of a controlled trial with the primary aim of exploring the effects of regular team interventions on drug prescribing practices in Swedish nursing homes. In 15 experimental nursing homes, the residents' drug therapy was discussed regularly by a team consisting of a pharmacist, a physician, nurses, undernurses (similar to licensed practical nurses), and nurse's aides. The pharmacist documented problems, made changes, and observed outcomes. Following the intervention period, a questionnaire was sent to the medical staff that contained items regarding perceived outcomes, the intervention's impact on knowledge of drug therapy in the elderly, and attitudes toward the pharmacist's role.
Unclear indication and problematic choice of drugs were the most common drug-related problems discussed. In 19% of the situations, therapy changes were reported to have had a beneficial effect on the residents' clinical status; in 47% of the situations, staff reported no observable outcome from changes, suggesting that the changes had been appropriate. Finally, medical staff claimed in the follow-up survey that their knowledge about drug therapy had increased; they expressed an overall positive attitude toward this interactive collaboration.
Regular intervention conducted by a multidisciplinary team incorporating a pharmacist can effectively improve prescribing practices, increase staff knowledge about appropriate drug therapy in the elderly, and result in improved quality of care for nursing home residents.
描述在瑞典15家养老院定期召开的团队会议中讨论的药物相关问题的类型和频率，并报告医生和工作人员对这些干预措施及居民治疗结果的评估。
数据收集于一项对照试验，其主要目的是探讨定期团队干预对瑞典养老院药物处方实践的影响。在15家试验性养老院中，由一名药剂师、一名医生、护士、助理护士（类似于执业护士）和护工组成的团队定期讨论居民的药物治疗。药剂师记录问题、做出更改并观察结果。干预期结束后，向医务人员发放了一份问卷，其中包含有关感知到的结果、干预对老年人药物治疗知识的影响以及对药剂师角色的态度等项目。
用药指征不明和药物选择不当是讨论最多的药物相关问题。在19%的情况下，据报告治疗更改对居民的临床状况产生了有益影响；在47%的情况下，工作人员报告更改未产生可观察到的结果，这表明更改是恰当的。最后，医务人员在后续调查中称他们对药物治疗的知识有所增加；他们对这种互动协作总体持积极态度。
由包含药剂师的多学科团队进行定期干预可有效改善处方实践，增加工作人员对老年人适当药物治疗的知识，并提高养老院居民的护理质量。
