COMMUNITY-BASED PHARMACEUTICAL CARE: A CONTROLLED TRIAL

描述：(摘自摘要)。使用反应性呼吸道疾病(RAD) 作为一个模型，申请者建议开发算法、材料和 促进药学护理的教育计划。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，当配药时。耐心教育 材料将被打印和录像。临床信息将会到来 从存储在网络中的患者的电子病历链接 6家医院、24家独立诊所和社区卫生中心，以及 印第安纳州中部的一家药房连锁店提供了一半的处方。这个 显示的临床信息将包括最大呼气流速 (PEFR)，最近住院或急诊室就诊的证据 呼吸系统疾病，以及计算的服药依从性指标 从重新装满的时间来看。这项试验的地点将是20家药店 在印第安纳波利斯中部(10人随机进入干预状态，10人进入对照组 状况)，位于六家联网计算机医院附近。成人患者患有 在一家研究药店装满大部分药物并使用其中一种的RAD 在六家急救医院中，将通过来自 连锁药店。 将有一个由460名患者组成的干预组(他们也将被 峰值流量计)和两个对照组：460名患者也给予峰值流量计 流量计和460名未使用流量计的患者进行控制以了解可能的效果 峰值流量计本身。那些同意参与的患者 将在基线、6个月和12个月时在他们的家中接受采访。这个 在居家期间将获得以下临床信息 访谈和每月电话，以补充他们的数据 计算机记录：最近呼吸道疾病的恶化，药物治疗 合规性和PEFR。共病信息和以下结果 数据也将在家庭访谈期间获得：与健康相关 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。 每名患者将接受为期一年的随访，在此期间， 干预的成本效益将根据患者的结果进行衡量 包括PEFR、呼吸道疾病急性加重、药物治疗 遵从性和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.