Impact of social prescribing on general practice workload and polypharmacy
Impact of social prescribing on general practice workload and polypharmacy
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DOI：
10.1016/j.puhe.2017.03.010
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发表时间：
2017-07-01
期刊：
影响因子：
5.2
通讯作者：
McCarron, M. O.
中科院分区：
文献类型：
--
作者：
Loftus, A. M.;McCauley, F.;McCarron, M. O.
目的：社会处方已成为帮助患者克服健康状况不佳的一些社会和行为决定因素的有用工具。关于社会处方对初级卫生保健资源使用的影响的研究很少。本研究旨在确定社会处方活动是否影响患者全科医生（GP）的接触和polypharmacy.Study设计：从北方爱尔兰的城市全科实践与社会处方活动干预的质量改进设计。方法：65岁以上的慢性病患者经常参加他们的GP或有多种药物提供了社会处方活动。参与者的接触GP和新的重复处方之前和期间的社会处方活动进行了测量。在转诊时和6-12个月后比较每例患者重复处方的总数。转诊，主要诊断和原因，减少参与社会处方活动后，转介prospectively recorded.Results：68例患者同意参加，但只有28（41%）从事规定的社会活动。在转诊和完成12周社会处方活动之间，GP接触（访问GP、家访或电话）或新的重复处方数量无统计学显著差异。同样，在意向治疗或符合方案分析中，转诊与社会处方活动后6-12个月之间的重复处方总数无统计学显著差异。社会处方参与者有类似的人口统计学因素。心理健康问题（焦虑和/或抑郁）是更常见的参与者比那些谁是指，但拒绝参与社会处方活动（P = 0.022）。结论：虽然社会处方可能有助于患者的自尊和幸福，它可能不会减少GP的工作量。需要进一步研究以优化社会处方效益。(C)2017年皇家公共卫生学会。由爱思唯尔有限公司出版。保留所有权利。
Objectives: Social prescribing has emerged as a useful tool for helping patients overcome some of the social and behavioural determinants of poor health. There has been little research on the impact of social prescribing on use of primary healthcare resources. This study sought to determine whether social prescribing activities influenced patient-general practitioner (GP) contacts and polypharmacy.Study design: Quality-improvement design with social prescribing activity interventions from an urban general practice in Northern Ireland.Methods: Patients over 65 years of age with a chronic condition who attended their GP frequently or had multiple medications were offered a social prescribing activity. Participants' contacts with GP and the new repeat prescriptions before and during the social prescribing activity were measured. The total number of repeat prescriptions per patient was compared at the time of referral and 6-12 months later. Indications for referral, primary diagnoses and reasons for declining participation in a social prescribing activity after referral were prospectively recorded.Results: Sixty-eight patients agreed to participate but only 28 (41%) engaged in a prescribed social activity. There was no statistically significant difference in GP contacts (visits to GP, home visits or telephone calls) or number of new repeat prescriptions between referral and completion of 12 weeks of social prescribing activity. Similarly there was no statistically significant difference in the total number of repeat prescriptions between referral and 6-12 months after social prescribing activity in either intention to treat or per protocol analyses. Social prescribing participants had similar demographic factors. Mental health issues (anxiety and/or depression) were more common among participants than those who were referred but declined participation in a social prescribing activity (P = 0.022).Conclusions: While social prescribing may help patients' self-esteem and well-being, it may not decrease GP workload. Further research is required to optimise social prescribing benefits. (C) 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.