オンタリオ州におけるオピオイド投与開始と薬剤師による薬剤レビューにおける地域的および時間的変動の評価:人口を基にした繰り返し横断的な研究
Amir Torabi1, Cherry Chu2, Yasmin Abdul Aziz1,3
1Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON.
まとめ
コミュニティの薬局では高用量オピオイドの処方箋が減ったが,薬の評価は一貫していない. これらの品質指標は,薬局の実践と患者のケアを改善するための分野を強調しています.
科学分野:
- 薬局の実践
- 医療サービス研究
- 公衆衛生
背景:
- 医療サービスの評価には品質指標 (QI) が不可欠ですが,薬局では十分に活用されていません.
- この研究では,コミュニティの薬局での2つの主要なQIの傾向を調査しています.
研究 の 目的:
- 2つの確立された薬局品質指標における時間的傾向と地域的変動を分析する.
- 10年間にわたる介入や実践の変化の有効性を評価する.
主な方法:
- カナダのオンタリオ州 (2013年−2023年) の行政データを用いて,繰り返し実施された横断試験の設計.
- 2つのQIの分析: (1) 新しいオピオイド処方箋の割合>50MME,および (2) 薬剤師による解禁後の薬剤の見直し.
- 統計的分析には,地域差の分散計算と時間的傾向のマン・ケンドールテストが含まれていた.
主要な成果:
- 高用量オピオイドの処方薬 (MME50を超える) は省全体で10.5%減少し,都市部ではさらに減少した.
- 薬剤の利用率の見直しでは,当初は減少したが,その後は部分的に回復し,農村部では都市部よりも高い割合を示した.
- 地域差は明らかで,地理的に異なる地域での実施や効果が異なっていた.
結論:
- 地域薬局は,高用量オピオイドの処方量を成功裏に削減し,積極的な実践の変化を示しています.
- 薬剤師による薬剤のレビューの不一致は,特に都市部で,薬剤の遵守とアクセシビリティを改善するための標的型戦略の必要性を強調しています.
- QIの継続的なモニタリングの重要性を強調し,コミュニティの薬局における実践のギャップを特定し,対処します.
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