Improving the Effectiveness of Medication Review: Guidance from the Health Literacy Universal Precautions Toolkit
Improving the Effectiveness of Medication Review: Guidance from the Health Literacy Universal Precautions Toolkit
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DOI：
10.3122/jabfm.2016.01.150163
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发表时间：
2016-01-01
影响因子：
2.9
通讯作者：
West, David R.
中科院分区：
文献类型：
--
作者：
Weiss, Barry D.;Brega, Angela G.;West, David R.
背景资料：虽然建议在初级保健实践中进行常规药物审查，以确定药物治疗问题，但通常很难让患者将所有药物带到办公室就诊。本研究的目的是确定医疗保健研究和质量健康素养通用预防措施工具包的机构中的药物审查工具是否可以帮助改善药物审查在初级保健practices.Methods：该工具包的“布朗袋药物审查”实施在农村私人执业在密苏里州和城市教学实践在加州。实践记录了45例患者在工具包实施前的药物审查结果，然后根据工具包中的指导改变了他们的药物审查流程。六个月后，我们与实践工作人员进行了访谈，以确定实施该工具所带来的变化，实践记录了另外41名患者的药物审查结果。数据分析比较差异是否所有的药物都带来了访问，药物审查，药物治疗问题的数量，并在药物治疗方案的变化之前和之后implementation.Results：访谈显示，做法作出了改变，建议在工具包中，鼓励患者把药物带到办公室访问。实施前后的评估显示，携带所有处方药的患者百分比增加了3倍，携带处方药到办公室就诊的数量增加了6倍。药物治疗的问题被确定的审查的百分比增加了一倍，药物治疗方案的百分比reviewed.Conclusions：使用的健康素养通用预防措施工具包可以帮助确定药物治疗的问题。
Background: Although routine medication reviews in primary care practice are recommended to identify drug therapy problems, it is often difficult to get patients to bring all their medications to office visits. The objective of this study was to determine whether the medication review tool in the Agency for Healthcare Research and Quality Health Literacy Universal Precautions Toolkit can help to improve medication reviews in primary care practices.Methods: The toolkit's "Brown Bag Medication Review" was implemented in a rural private practice in Missouri and an urban teaching practice in California. Practices recorded outcomes of medication reviews with 45 patients before toolkit implementation and then changed their medication review processes based on guidance in the toolkit. Six months later we conducted interviews with practice staff to identify changes made as a result of implementing the tool, and practices recorded outcomes of medication reviews with 41 additional patients. Data analyses compared differences in whether all medications were brought to visits, the number of medications reviewed, drug therapy problems identified, and changes in medication regimens before and after implementation.Results: Interviews revealed that practices made the changes recommended in the toolkit to encourage patients to bring medications to office visits. Evaluation before and after implementation revealed a 3-fold increase in the percentage of patients who brought all their prescription medications and a 6-fold increase in the number of prescription medications brought to office visits. The percentage of reviews in which drug therapy problems were identified doubled, as did the percentage of medication regimens revised.Conclusions: Use of the Health Literacy Universal Precautions Toolkit can help to identify drug therapy problems.