COMMUNITY-BASED PHARMACEUTICAL CARE: A CONTROLLED TRIAL

描述：（摘自摘要）。 反应性气道疾病（RAD） 作为一个模型，申请人提出开发算法、材料和 教育计划，以促进药学服务。 他们提议 进行随机对照试验。 他们将提供发达的 材料和患者特定的临床信息，显示在其 计算机工作站，当填写处方。 患者教育 材料将被打印和录像。 临床信息将来自 从病人的电子医疗记录中， 6家医院、24家独立诊所和社区保健中心， 印第安纳州中部一半的处方药都是由连锁药店提供的 的 所显示的临床信息将包括呼气流速峰值 （PEFR），最近住院或急诊室就诊的证据， 呼吸系统疾病，并计算药物依从性指标 从重新填充的时间。 本试验将在20家药店进行 在印第安纳波利斯中部（10名随机分配到干预状态，10名为对照 位于六家计算机联网医院附近。 成人患者 RAD在研究药店之一灌装大部分药物并使用其中一种 六家医院的急性护理将被招募的信， 连锁药店 将有一个由460名患者组成的干预组（他们也将接受 峰值流量计）和两个对照组：460例患者也给予峰值流量计。 流量计和460名无流量计的患者，以控制可能的影响 峰值流量计本身。 同意参加的患者 将在基线、6个月和12个月时在家中接受采访。 的 将在居家期间获得以下临床信息 通过每月电话访谈， 计算机记录：最近呼吸道疾病加重，药物治疗 遵守和PEFR。 科摩罗信息和以下结果 还将在家庭访谈中获得数据： 生活质量（HRQOL），对医疗保健的满意度，以及 对药剂师和药房的满意度。 药剂师的工作 对药学服务的满意度和态度也将进行评估。 每例患者将随访1年，在此期间， 干预的成本效益将根据患者结局进行衡量 包括PEFR、呼吸道疾病急性加重、药物治疗 和HRQOL。

DESCRIPTION: (taken from abstract). Using reactive airways disease (RAD) as a model, the applicants propose to develop algorithms, materials, and an educational program to facilitate pharmaceutical care. They propose to conduct a randomized, controlled trial. They will provide developed materials and patient-specific clinical information, displayed on their computer workstations, when filling prescriptions. The patient educational materials will be printed and videotaped. Clinical information will come from the patients' electronic medical records stored in a network linking six hospitals, 24 free-standing clinics and neighborhood health centers, and a pharmacy chain filling half the prescriptions in Central Indiana. The clinical information displayed will include peak expiratory flow rates (PEFRs), evidence of recent hospitalizations or emergency room visits for respiratory disease, and an indicator of medication compliance calculated from the timing of refills. The sites for this trial will be 20 drugstores in central Indianapolis (10 randomized to intervention status, 10 to control status) located near the six computer-linked hospitals. Adult patients with RAD who fill most of their drugs at one of the study drugstores and use one of the six hospitals for acute care will be recruited by a letter from the drugstore chain. There will be one intervention group of 460 patients (who will also be given peak flow meters) and two control groups: 460 patients also given a peak flow meter and 460 patients without meters to control for a possible effect of the peak flow meters themselves. Those patients who agree to participate will be interviewed in their homes at baseline, 6, and 12 months. The following clinical information will be obtained during the in-home interviews and from monthly telephone calls to supplement data in their computer records: recent exacerbations of respiratory disease, medication compliance, and PEFR. Comorbidity information and the following outcome data will also be obtained during the in-home interviews: health-related quality of life (HRQOL), satisfaction with their health care, and satisfaction with their pharmacists and pharmacy. Pharmacists' job satisfaction and attitudes toward pharmaceutical care will also be assessed. Each patient will be followed for 1 year during which the effectiveness and cost-effectiveness of the intervention will be measured on patient outcomes that include PEFR, acute exacerbations of respiratory disease, medication compliance, and HRQOL.