Pharmacist-led medication review in patients over 65: a randomized, controlled trial in primary care
Pharmacist-led medication review in patients over 65: a randomized, controlled trial in primary care
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DOI：
10.1093/ageing/30.3.205
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发表时间：
2001-05-01
期刊：
影响因子：
6.7
通讯作者：
Seymour, DG
中科院分区：
文献类型：
--
作者：
Krska, J;Cromarty, JA;Seymour, DG
背景：对于75岁以上的患者和正在接受多种药物治疗的患者，建议定期进行药物复查。药剂师是审查药物的潜在援助来源。目的：研究由药剂师领导的药物审查对解决药学服务问题、药物成本、健康和社会服务的使用以及健康相关的生活质量的影响。设计：随机对照试验。设置：苏格兰格兰扁地区的一般医疗实践。受试者：患者年龄至少65岁，至少有两种慢性疾病状态，并定期服用至少四种处方药。方法：药师回顾了332例患者的药物治疗，使用从实践计算机，病历和患者访谈中获得的信息。在168名患者中，制定并实施了药物护理计划。164名对照患者继续接受正常护理。所有结果的措施进行了评估，在基线和3 months.Results后：所有患者在基线时至少有两个药学服务的问题。其中一半是从处方记录中确定的，其余的是从笔记和患者访谈中确定的。在所有问题中，21%通过记录中的信息解决，8.5%通过患者访谈解决。全科医生同意96%的所有护理问题记录在干预组的护理计划。在随访时，干预组70%的剩余护理问题得到解决，而对照组只有14%得到解决。两组的药物费用或健康相关的生活质量没有变化。有小的增加与卫生保健专业人员的接触和干预组之间的住院人数略少于control group.Conclusions：药师主导的药物审查有能力识别和解决药学服务问题，并可能对其他卫生服务的使用产生一定的影响。
Background: regular medication review has been recommended for those over 75 and those on multiple drug therapy. Pharmacists arc a potential source of assistance in reviewing medication. Evidence of the benefits of this process is needed.Objective: to study the effect of medication review led by a pharmacist on resolution of pharmaceutical care issues, medicine costs, use of health and social services and health-related quality of life.Design: randomized, controlled trial.Setting: general medical practices in the Grampian region of Scotland.Subjects: patients aged at least 65 years, with at least two chronic disease states who were taking at least four prescribed medicines regularly.Methods: pharmacists reviewed the drug therapy of 332 patients, using information obtained from the practice computer, medical records and patient interviews. In 168 patients, a pharmaceutical care plan was then drawn up and implemented. The 164 control patients continued to receive normal care. All outcome measures were assessed at baseline and after 3 months.Results: all patients had at least two pharmaceutical care issues at baseline. Half of these were identified from the prescription record, the rest from notes and patient interview. Of all the issues, 21% were resolved by information found in notes and 8.5% by Patient interview. General practitioners agreed with 96% of all care issues documented on the care plans in the intervention group. At the time of follow-up, 70% of the remaining care issues had been resolved in the intervention group, while only 14% had been resolved in the control group. There were no changes in medicine costs or health-related quality of life in either group. There were small increases in contacts with health-care professionals and slightly fewer hospital admissions among the intervention group than the control group.Conclusions: pharmacist-led medication review has the capacity to identify and resolve pharmaceutical care issues and may have some impact on the use of other health services.