Assessment of a computerised decision support system for allergic rhino-conjunctivitis counselling in German pharmacy
Assessment of a computerised decision support system for allergic rhino-conjunctivitis counselling in German pharmacy
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DOI：
10.1007/s11096-011-9584-0
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发表时间：
2012-02-01
影响因子：
2.4
通讯作者：
Haefeli, Walter E.
中科院分区：
文献类型：
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作者：
Bertsche, Thilo;Nachbar, Markus;Haefeli, Walter E.
目的在一项前瞻性两期干预研究中，我们评估了新开发的计算机化药房决策支持系统（PDSS）对变应性鼻炎和结膜炎患者的咨询。方法邀请社区药师对虚拟患者进行第一次面谈。紧接着，我们培训药剂师操作PDSS，他们在培训后的第二次病人访谈中应用了PDSS。我们评估了国家指南规定的强制性问题的完整性。结果参与调查的药师（n = 50, 78%为女性，平均年龄34岁[IQR: 27-40]岁，有8年[2-14.5]年的实践经验，32%为社区药房专业）在确认自我药疗适当性方面提出了更多的强制性问题，其中9个问题中有7个（5.25-9;78%），而没有PDSS的有2个（1-3;22%）（中位数，P < 0.001）。特别是，使用PDSS与适当的药物选择相关的强制性问题（9/ 12,6.25 -10;75% vs. 4/ 12,3 -5; 33%; P < 0.001）增加了一倍以上。结论药师在评估自我药疗是否合适时省略了许多强制性问题。使用新开发的PDSS，强制性问题的数量增加了一倍以上。结果表明，PDSS已经准备好评估其对实际患者的影响。
Objective In a prospective two-phase intervention study we evaluated a newly developed computerised pharmacy decision support system (PDSS) for the counselling of patients with allergic rhinitis and conjunctivitis. Method Community pharmacists were invited to counsel a virtual patient in a first interview. Immediately thereafter, we trained pharmacists to operate the PDSS, which they applied in a second patient interview immediately following the training. We assessed the completeness of mandatory questions asked as defined by national guidelines. Results Participating pharmacists (n = 50, 78% female, mean age 34 [IQR: 27-40] years, 8 [2-14.5] years of practical experience, 32% specialised in community pharmacy) asked considerably more mandatory questions to confirm appropriateness of self-medication with 7 (5.25-9; 78%) from 9 questions compared to 2 (1-3; 22%) without PDSS (median; P < 0.001). In particular, using the PDSS more than doubled mandatory questions (9/12, 6.25-10; 75% vs. 4/12, 3-5; 33%; P < 0.001) relevant for appropriate drug selection. Conclusion Pharmacists omitted many questions mandatory to assess whether self-medication is appropriate. Using the newly developed PDSS more than doubled the number of mandatory questions asked. The results suggest that the PDSS is ready for evaluation of its impact in real patients.