Nationwide Study on Relations between Workload and Outcomes of Home Visiting Service by Community Pharmacists
Nationwide Study on Relations between Workload and Outcomes of Home Visiting Service by Community Pharmacists
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DOI：
10.1248/yakushi.14-00220
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发表时间：
2015-03-01
影响因子：
0.3
通讯作者：
Arakawa, Yukio
中科院分区：
文献类型：
--
作者：
Onda, Mitsuko;Imai, Hirohisa;Arakawa, Yukio
在全国范围内进行调查，验证社区药师家访服务工作量与结果的关系。数据收集自1890家药店的5447名患者。大多数（61.9%）药剂师每月两次到病人家中，平均花费20.6分钟的工作时间。在调查时，与家访开始时相比，29.8%的患者依从性有所改善；65.5%的人没有变化，1.4%的人变得更糟。同样，41.6%的人减少了未使用的药物，54.4%的人没有变化，2.3%的人增加了。家访药师发现14.4%的患者出现药物不良事件（ade）。其中44.2%的病例通过停药处理，24.5%通过减少剂量处理，18.3%通过更换药物处理，总共88.1%的病例得到改善。37.1%的患者改变处方是为了纠正问题。在药剂师更经常拜访的病人中，有更高比例的人有不良反应，他们的处方被更改以纠正问题，并且依从性和未使用的药物得到改善。结果改善的患者的平均实际工作时间比结果没有改善的患者长。较高的参与家庭护理药剂师被发现改善药物治疗的结果。
A nationwide survey was conducted to verify relations between the workload of home-visiting service by community pharmacists and outcomes. Data were collected on 5447 patients from 1890 pharmacies. Most (61.9%) pharmacists visited patients' homes twice monthly, spending there a net average of 20.6 work minutes. At the time of the survey, 29.8% of the patients had improvement of adherence compared with at start of home visits; 65.5% had no change, and 1.4% had gotten worse. Similarly, 41.6% had decreased unused medications, 54.4% had no change, and 2.3% had increased. Home-visiting pharmacists found adverse drug events (ADEs) caused by drug administration in 14.4% of their patients. They dealt with 44.2% of these cases by discontinuing administration of the responsible drug, 24.5% by reducing the dosage, and 18.3% by changing drugs, with a total of 88.1% having been improved. Prescription changes intended to correct problems occurred in 37.1% of the patients. In patients whom the pharmacists visited more often, a higher percent had ADEs, had their prescription changed to correct problems, and had improved adherence and unused medications. The average actual work time was longer in patients whose outcomes improved than in those whose outcomes did not. A higher involvement in homecare by pharmacists was found to improve outcomes of drug treatment.