在社区终身护理中提前处方
Charlotte Lee1, Theresa Tammy Tran2, Joy Ross2
1St Christopher's Hospice, London, UK charlotte.lee16@nhs.net.
BMJ supportive & palliative care
|October 18, 2023
概括
在临床医院处方的预期药物可能不需要所有四种标准药物. 个人处方的反药被证明是安全的,具有成本效益,并减少了浪费,挑战了传统做法.
科学领域:
- 抚慰性护理是一种缓解性护理.
- 药理学 药理学是指药理学的学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 预期性药物通常在临终关怀中被处方,以管理生命末期的症状.
- 当前的处方做法往往遵循标准化治疗方案,可能导致过度使用或不适当的药物选择.
研究的目的:
- 批判性地审查预期药物的使用在内城住院人口.
- 评估当前处方实践的适当性和影响.
主要方法:
- 一个追溯审计76社区息护理患者在生命末期处方预期药物.
- 对预期图表和案例笔记的审查.
- 干预包括指导方针更新,处方者教育,以及18个月后重新审核以评估影响.
主要成果:
- 最初,99%的患者接受了止痛药,抗,抗分泌药和抗焦虑药.
- 再审计显示,抗分泌剂的处方减少了57%,抗的处方减少了50%.
- 实施了个性化抗emetic处方 (levomepromazine,haloperidol,cyclizine,metoclopramide),没有在没有处方的患者中发现后续需要.
结论:
- 质疑了所有四种标准预测药物总是必要的假设.
- 针对个人的抗药处方是安全的,具有成本效益,并减少了药物浪费.
- 需要进一步的研究来评估在不同环境中改变实践的影响.
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