改善初级保健中多药患者的药物使用 (IMPPP):多中心集群随机试验的协议,将药物优化复杂干预与常规护理进行比较
Rupert A Payne1, Peter S Blair2, Barbara Caddick1
1Centre for Academic Primary Care, University of Bristol, Bristol, UK.
NIHR open research
|October 26, 2023
概括
这项研究评估了一项旨在优化多药患者药物使用的干预措施. 这项涉及结构化药物审查和专业间合作的干预措施旨在减少可能不适当的处方指标.
科学领域:
- 初级护理研究初级护理研究
- 临床药理学 临床药理学
- 医疗服务研究 医疗服务研究
背景情况:
- 多药是一种日益关注的问题,往往导致不良结果.
- 目前的多药店管理指南缺乏可靠的证据.
- 在多种药物治疗的患者中,优化药物使用至关重要.
研究的目的:
- 评估复杂干预措施的有效性,以优化初级保健患者的药物使用.
- 在这个人群中减少潜在不适当处方 (PIP) 指标的发生率.
- 评估对患者报告结果和医疗保健服务利用的影响.
主要方法:
- 一个多中心,开放标签,集群随机对照试验,涉及37个一般实践.
- 干预组接受了结构化药物审查,跨专业的GP/药剂师规划,患者参与,绩效反,财务激励,培训和临床信息学.
- 对照组接受了通常的护理. 招募了具有多药和PIP指标的患者,并在26周内进行了跟踪.
主要成果:
- 主要结局是26周每名患者的PIP指标平均数.
- 二次结果包括患者报告的结果措施和卫生/护理服务的使用.
- 分析使用线性混合效应回归,根据基线值进行调整.
结论:
- 该IMPPP试验提供了对初级保健中多药管理的多方面的干预措施的严格评估.
- 研究结果将为优化药物使用和降低处方风险的基于证据的策略提供信息.
- 传播将针对医疗保健专业人员,政策制定者和患者.
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