Interface management of pharmacotherapy. Joint hospital and primary care drug recommendations
Interface management of pharmacotherapy. Joint hospital and primary care drug recommendations
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DOI：
10.1007/s00228-013-1497-5
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发表时间：
2013-05-01
影响因子：
2.9
通讯作者：
Gustafsson, Lars L.
中科院分区：
文献类型：
--
作者：
Bjorkhem-Bergman, Linda;Andersen-Karlsson, Eva;Gustafsson, Lars L.
2012年9月，斯德哥尔摩药物和治疗委员会与瑞典斯德哥尔摩卡罗林斯卡医学院和卡罗林斯卡大学医院临床药理学部合作，与世卫组织合作，组织了一次关于“药物治疗界面管理”的互动课程。课程的基础是合理使用药物的“斯德哥尔摩模式”，但也包括介绍其他欧洲国家药物治疗界面管理的成功模式。方法“斯德哥尔摩模型”由8个组成部分组成：1)独立的药物和治疗委员会，由受人尊敬的药物专家发挥关键作用，制定“冲突利益”政策，2)“明智清单”，联合推荐初级和医院保健药物，3)持续医学教育的沟通策略，4)系统引入新的昂贵药物，5)“护理点”的电子药理学支持，6)药物使用随访的方法和工具，7)药物政策策略和8)手术资源。结果课程强调了有效和有针对性的药物建议沟通的重要性，建立在处方者和患者之间的信任，以实现指南的高依从性。信任是由独立的药物和治疗委员会实现的，该委员会由受人尊敬的专家发挥关键作用，并对“利益冲突”采取严格的政策。作为循证医学与实践之间的纽带，全科医生的陈述对成功实施也至关重要。结论：苏格兰和斯德哥尔摩的成功模式以及加泰罗尼亚正在进行的工作被认为是采取多方面方法提高初级和医院医疗使用质量的例子。
Purpose In September 2012 an interactive course on the "Interface Management of Pharmacotherapy" was organized by the Stockholm Drug and Therapeutics Committee in cooperation with Department of Clinical Pharmacology at Karolinska Institutet and at Karolinska University Hospital in Stockholm, Sweden, in collaboration with the WHO. The basis for the course was the "Stockholm model" for the rational use of medicines but also contained presentations about successful models in interface management of pharmacotherapy in other European countries.Methods The "Stockholm model" consists of 8 components: 1) Independent Drug and Therapeutics Committee with key role for respected drug experts with policy for "interest of conflicts", 2) The "Wise List", recommendations of medicines jointly for primary and hospital care, 3) Communication strategy with continuous medical education, 4) Systematic introduction of new expensive medicines, 5) E-pharmacological support at "point of care", 6) Methods and tools for follow-up of medicines use, 7) Medicines policy strategy and 8) Operative resources.Results The course highlighted the importance of efficient and targeted communication of drug recommendations building on trust among prescribers and patients for the guidelines to achieve high adherence. Trust is achieved by independent Drug and Therapeutics Committees with a key role for respected experts and a strict policy for "conflicts of interest". Representations of GPs are also crucial for successful implementation, being the link between evidence based medicine and practice.Conclusion The successful models in Scotland and in Stockholm as well as the ongoing work in Catalonia were considered as examples of multifaceted approaches to improve the quality of medicine use across primary and hospital care.