Assessing the extent of drug interactions among patients with multimorbidity in primary and secondary care in the West Midlands (UK): a study protocol for the Mixed Methods Multimorbidity Study (MiMMS).
Assessing the extent of drug interactions among patients with multimorbidity in primary and secondary care in the West Midlands (UK): a study protocol for the Mixed Methods Multimorbidity Study (MiMMS).
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DOI：
10.1136/bmjopen-2017-016713
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发表时间：
2017-09-18
期刊：
影响因子：
2.9
通讯作者：
Litchfield I
中科院分区：
文献类型：
--
作者：
Backman R;Weber P;Turner AM;Lee M;Litchfield I
患有三种或三种以上慢性病(多发病)的患者数量正在增加，仅在英国到2018年就将增加到290万。目前在英国，主要使用超过250套单一条件指导来管理条件，这可能会为患有多种条件的个别患者产生相互矛盾的生活方式和同时用药建议。为了解决其中一些问题，我们正在开发一种新的基于计算机的工具，以帮助更有效地管理这些患者。为了使这一工具适用于当前的实践并与之相关，我们首先必须更好地了解如何管理现有的多病患者，特别是与对处方和潜在的多药联用的担忧有关的问题。将在西米德兰兹郡招募多达四个二级护理中心、两个社区药房和四至八个初级护理中心。受访者将从这些地点有目的地抽样，最多30人。在这项混合方法研究中，我们将对定性数据进行双重框架分析；第一个分析将使用理论领域框架来评估医疗专业人员在多病患者管理方面的障碍和促进因素；第二个分析将使用正常化过程理论来了解目前如何在两种环境中成功实施干预措施。我们还将从初级保健中提取匿名的量化患者数据，以确定西米德兰兹郡目前存在的多发病患者的多种药物治疗的程度。我们的目标是将这些数据结合在一起，这样我们就可以建立一个有用的、完全可实施的工具，解决在初级和二级保健背景下最容易改变的障碍。伯明翰大学研究伦理委员会(ERN_16-0074)于2016年5月17日批准了有利的伦理批准。我们的工作将通过同行评议的文献、行业期刊和会议进行传播。我们还将使用大学托管的专用网页作为中心联络点和我们调查结果的储存库。我们的目标是从这项工作中至少制作三篇文章，为国际科学文献做出贡献。NIHR临床研究网络组合注册CPMS ID 30613。
The numbers of patients with three or more chronic conditions (multimorbidity) are increasing, and will rise to 2.9 million by 2018 in the UK alone. Currently in the UK, conditions are mainly managed using over 250 sets of single-condition guidance, which has the potential to generate conflicting recommendations for lifestyle and concurrent medication for individual patients with more than one condition. To address some of these issues, we are developing a new computer-based tool to help manage these patients more effectively. For this tool to be applicable and relevant to current practice, we must first better understand how existing patients with multimorbidity are being managed, particularly relating to concerns over prescribing and potential polypharmacy. Up to four secondary care centres, two community pharmacies and between four and eight primary care centres in the West Midlands will be recruited. Interviewees will be purposively sampled from these sites, up to a maximum of 30. In this mixed methods study, we will perform a dual framework analysis on the qualitative data; the first analysis will use the Theoretical Domains Framework to assess barriers and enablers for healthcare professionals around the management of multimorbid patients; the second analysis will use Normalisation Process Theory to understand how interventions are currently being successfully implemented in both settings. We will also extract quantitative anonymised patient data from primary care to determine the extent of polypharmacy currently present for patients with multimorbidity in the West Midlands. We aim to combine these data so that we can build a useful, fully implementable tool which addresses the barriers most amenable to change within both primary and secondary care contexts. Favourable ethical approval has been granted by The University of Birmingham Research Ethics Committee (ERN_16–0074) on 17 May 2016. Our work will be disseminated through peer-reviewed literature, trade journals and conferences. We will also use the dedicated web page hosted by the University to serve as a central point of contact and as a repository of our findings. We aim to produce a minimum of three articles from this work to contribute to the international scientific literature. NIHR Clinical Research Network Portfolio Registration CPMS ID 30613.
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DOI：
10.1186/1748-5908-7-93
发表时间：
2012-09-21
期刊：
Implementation science : IS
影响因子：
--
作者：
Islam R;Tinmouth AT;Francis JJ;Brehaut JC;Born J;Stockton C;Stanworth SJ;Eccles MP;Cuthbertson BH;Hyde C;Grimshaw JM
通讯作者：
Grimshaw JM
影响因子：
5.1
作者：
Berenbaum, Francis
通讯作者：
Berenbaum, Francis
影响因子：
7.2
作者：
Duncan, Eilidh M.;Francis, Jill J.;Bond, Christine
通讯作者：
Bond, Christine
初级保健临床医生对有多种疾病的老年人进行治疗决策的经验。
影响因子：
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作者：
Fried, Terri R.;Tinetti, Mary E.;Iannone, Lynne
通讯作者：
Iannone, Lynne
DOI：
10.1186/1748-5908-7-77
发表时间：
2012-08-28
期刊：
Implementation science : IS
影响因子：
--
作者：
Boscart VM;Fernie GR;Lee JH;Jaglal SB
通讯作者：
Jaglal SB