Variations in drug-related problems detected by multidisciplinary teams in Norwegian nursing homes and home nursing care
Variations in drug-related problems detected by multidisciplinary teams in Norwegian nursing homes and home nursing care
复制标题
DOI：
10.1080/02813432.2018.1499581
复制
发表时间：
2018-01-01
影响因子：
2.1
通讯作者：
Enmarker, Ingela
中科院分区：
文献类型：
--
作者：
Devik, Sid A.;Olsen, Rose Mad;Enmarker, Ingela
目的：传统上，养老院与次优药物治疗和药物相关问题（DRPs）有关。相比之下，人们对家庭护理中的药物安全知之甚少。本研究的目的是描述和比较两种护理环境中老年人的drp：养老院和家庭护理。设计：采用描述性和推断性统计的横断面研究。环境：挪威中部9个城市的养老院（n=5）和家庭护理单位（n=8）。参与者：对2013-2014年期间61名养老院居民和93名接受家庭护理的患者进行多学科药物评价，并进行绘图和检查（N=154）。主要结果测量：挪威分类工具对DRPs进行分类。结果：共检出drp 740例，其中养老院227例，家庭护理513例。接受家庭护理的患者（平均=5.5）的drp显著高于在养老院的患者（平均=3.7,p=0.002）。在问题类别中，需要额外药物的情况在疗养院最为常见（p=0.001），而文件差异在接受家庭护理的患者中达到最高（p=0.000）。此外，家庭护理患者在不良反应方面存在更多问题（p=0.060）；然而，这在统计学上并不显著。还发现DRP类别的差异导致患者药物清单的变化。结论：在家庭护理环境中发现的文件不清楚和不良反应的频率是惊人的。这是一个重要的问题，考虑到老年人在自己家里照顾的趋势。需要进一步的研究来探讨不同的护理环境如何影响老年人药物治疗的安全性。
Objective: Traditionally, nursing homes have been associated with suboptimal drug therapy and drug-related problems (DRPs). In contrast, less is known about drug safety in homecare. The aim of this study was to describe and compare DRPs in older persons across two care settings: nursing homes and home nursing care.Design: Cross-sectional study using descriptive and inferential statistics.Setting: Nursing homes (n=5) and home nursing care units (n=8) across nine municipalities in the middle of Norway.Participants: Multidisciplinary medication reviews for 61 nursing home residents and 93 patients receiving home nursing care performed over the 2013-2014 period, were mapped and examined (N=154).Main outcome measures: DRPs classified by a Norwegian Classification Tool.Results: In all, 740 DRPs were detected in the total sample, 227 in nursing homes and 513 in home nursing care. DRPs were significantly higher among patients receiving home-based care (Mean =5.5) compared to patients in nursing homes (Mean =3.7, p=0.002). Among the problem categories, the need for additional drug was most frequent in nursing homes (p=0.001), while documentation discrepancies reached the highest numbers in patients receiving home nursing care (p=0.000). Additionally, patients in home nursing care had more problems concerning adverse reactions (p=0.060); however, this was not statistically significant. Differences in DRP categories leading to changes in the patients' medication lists were also discovered.Conclusions: The frequency of unclear documentation and adverse reactions found in the homecare setting is alarming. This is an important issue given the trend in aged care towards caring people in their own homes. Further research is warranted to explore how different care settings may influence the safety of pharmacotherapy for older persons.