Implementation of patient-centered prescription labeling in a safety-net ambulatory care network
Implementation of patient-centered prescription labeling in a safety-net ambulatory care network
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DOI：
10.2146/ajhp170821
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发表时间：
2018-08-15
影响因子：
2.7
通讯作者：
Sarkar, Urmimala
中科院分区：
文献类型：
--
作者：
Khoong, Elaine C.;Cherian, Roy;Sarkar, Urmimala
目的.介绍了在公共资助的安全网医疗保健系统内的4家药店实施以患者为中心的药物标签的倡议。药物不依从性对患者的结局和安全性产生负面影响。不依从归因于对药物标签上的说明理解不足。研究表明，以患者为中心的标签（PCL）可以提高依从性，并产生更安全的服药实践。作为安全网卫生系统混合方法研究的一部分，对4个药店产生的近9,000个处方标签进行了审计，并对6个利益相关者进行了访谈，以确定PCL采用率和成功因素。描述性统计被用来分析审计数据，实施研究的综合框架的结构被用来分析访谈数据。在4家研究中心中，3家药房成功将85%以上的经审核处方转换为PCL格式; 1家药房转换的处方不到25%。实施的障碍包括药剂师不愿意修改处方说明和转换率的实时数据不足。受访者认为，领导和政策指示促进PCL转换的努力。成功的药房使用适应性强的软件，与处方医生有更紧密的沟通网络，和/或使用自动化来促进PCL转换。三家药店成功地将超过85%的经审核处方标签转换为PCL格式;一家药店转换的处方不到25%。实施的障碍包括药剂师不愿意修改处方说明，会话率的实时数据不足，以及缺乏可定制的软件来自动更改。
Purpose. An initiative to implement patient-centered medication labeling at 4 pharmacies within a publicly funded safety-net healthcare system is described.Summary. Medication nonadherence negatively affects patient outcomes and safety. Nonadherence has been attributed to poor understanding of instructions on medication labels. Research has demonstrated that patient-centered labeling (PCL) can improve adherence and produce safer medication-taking practices. As part of a mixed-methods study by a safety-net health system, audits of nearly 9,000 prescription labels generated at 4 pharmacy sites, as well as interviews with 6 stakeholder informants, were conducted to determine PCL adoption rates and factors contributing to success. Descriptive statistics were used to analyze audit data; constructs of the Consolidated Framework for Implementation Research were used to analyze interview data. Among the 4 sites, 3 pharmacies successfully converted more than 85% of audited prescriptions to a PCL format; 1 pharmacy converted less than 25% of prescriptions. Barriers to implementation included pharmacists' reluctance to modify prescriber instructions and inadequate real-time data on conversion rates. Interviewees perceived that leadership and policy directives promoted PCL conversion efforts. Successful pharmacies used adaptable software, had closer communication networks with prescribers, and/or used automation to facilitate PCL conversion.Conclusion. Three pharmacies successfully converted more than 85% of labels for audited prescriptions to a PCL format; 1 pharmacy converted less than 25% of prescriptions. Barriers to implementation included pharmacists' reluctance to modify prescriber instructions, inadequate real-time data on conversation rates, and lack of customizable software to automate changes.