Application of the GheOP3S-tool in nursing home residents: acceptance and implementation of pharmacist recommendations
Application of the GheOP3S-tool in nursing home residents: acceptance and implementation of pharmacist recommendations
复制标题
DOI：
10.1080/17843286.2019.1634323
复制
发表时间：
2019-06-27
影响因子：
1.6
通讯作者：
Boussery, Koen
中科院分区：
文献类型：
--
作者：
Foubert, Katrien;Muylaert, Peter;Boussery, Koen
背景和目的：疗养院 (NH) 居民中潜在不当处方 (PIP) 的发生率很高。本研究旨在调查基于 PIP 筛选工具（根特老年人处方社区药房筛选 (GheOP(3)S) 工具）的药剂师建议的接受度和实施情况。背景和方法：对 NH 居民（≥ 70 岁，使用≥ 5 种药物）进行前瞻性观察研究，随访期为 3 个月。药剂师使用 GheOP(3)S 工具筛选药物清单，并制定减少 PIP 的建议。记录面对面药剂师-全科医生 (GP) 会议期间讨论的建议的接受情况。通过比较基线和后续药物清单来检查实施情况。慢性药物数量和 GheOP(3)S 标准的前后比较；通过药物负担指数（DBI）量化的抗胆碱能和镇静药物负担；并进行了药物费用。结果：使用 GheOP(3)S 工具进行筛选后，药剂师向 50 名 NH 居民提出了 168 条建议，主要是停止用药 (78.0%) 和替代用药 (14.3%)。 93% (156/168) 的建议被认为是相关的。全科医生的接受率为44.9%。所有已接受建议的 54% 已得到实施。随访时，慢性药物数量 (p = 0.007) 和 DBI 评分 (p = 0.004) 与基线显着不同。 GheOP(3)S 标准的数量 (p = 0.075) 和药物费用 (p > 0.05) 没有显着下降。结论：药师建议的接受度和实施率相对较低。未来的研究应该增加患者和所有医疗保健提供者的参与。跨学科合作以及对所有学科和患者的充分教育至关重要。
Background and objective: The prevalence of potentially inappropriate prescribing (PIP) among nursing home (NH) residents is high. This study aimed to investigate the acceptance and implementation of pharmacist recommendations based on a screening tool for PIP, the Ghent Older People's Prescriptions community Pharmacy Screening (GheOP(3)S)-tool. Setting and method: Prospective observational study in NH residents (>= 70 years, using >= 5 medications) with a 3-month follow-up period. A pharmacist screened the medication lists using the GheOP(3)S-tool and formulated recommendations to reduce PIP. The acceptance of recommendations discussed during face-to-face pharmacist-general practitioner (GP) meetings was recorded. Implementation was examined by comparing baseline and follow-up medication lists. A pre-post comparison of the number of chronic medications and GheOP(3)S-criteria; the anticholinergic and sedative burden quantified by the Drug Burden Index (DBI); and medication costs was performed. Results: Screening with the GheOP(3)S-tool resulted in 168 pharmacist recommendations for 50 NH residents, mainly to stop (78.0%) and to substitute (14.3%) medications. Ninety-three % (156/168) of recommendations were considered relevant. GPs acceptance rate was 44.9%. Fifty-four % of all accepted recommendations were implemented. At follow-up, the number of chronic medications (p = 0.007), and DBI scores (p = 0.004) significantly differed from baseline. There was no significant decrease in the number of GheOP(3)S-criteria (p = 0.075) and medication costs (p > 0.05). Conclusion: The acceptance and implementation of pharmacist recommendations were relatively low. Future studies should increase the involvement of patients and all health-care providers. Interdisciplinary collaboration with sufficient education for all disciplines and patients is essential.