实施药物审查以优化瑞士养老院的药物使用:一项混合方法研究
Stephanie Mena1,2,3, Julie Dubois4,5, Marie Schneider6,7
1Department of Policlinics, Community Pharmacy, Unisanté, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland. stephanie.mena@unisante.ch.
BMC health services research
|July 8, 2025
概括
在一个试点项目中,在养老院的药物审查 (MR) 成功减少了83%的与药物有关的问题 (DRP). 十分之七的医疗机构继续提供这项服务,认为这对患者护理是可行的和有效的.
科学领域:
- 老年人药房 老年人药房
- 实施科学 实施科学
- 医疗保健服务研究 医疗保健服务研究
背景情况:
- 养老院中的多种药品有助于与药物相关的问题 (DRPs),包括潜在不合适的药物 (PIMs).
- 药物审查 (MR) 对于解决DRP至关重要,但其在养老院环境中的实施往往被低估.
- 养老院药物评价 (MRNH) 试点项目旨在重组药房服务,以提供以患者为中心,跨专业的MR.
研究的目的:
- 评估瑞士养老院的专业间MR服务的实施过程.
- 评估MR对DRP解决方案的影响.
- 确定在这种环境中促进或阻碍MR实施的因素和策略.
主要方法:
- 一项采用3型混合实施-有效性设计的观察性研究,并进行混合的定量和定性分析.
- 使用药房服务实施框架 (FISpH) 和RE-AIM框架来定义结果.
- 通过问卷,焦点小组和行政记录收集数据,对DRP解决方案进行四个月的跟踪.
主要成果:
- 十个养老院中有七个满足了对其10%人口进行MR的目标,导致55个MR.
- 在MR后提出的145个治疗修改中,有128个得到实施,120个在随访期间保持.
- MRs导致检测到的DRPs的部分或完全解决率为83%,七个设施在项目后继续 MRs.
结论:
- 在大多数参与设施中,在养老院实施MR是成功的.
- 发现MR服务是可行的,被医疗保健专业人员接受,并建议进行更广泛的传播.
- 调查结果支持将MR服务扩展到更多的养老院,并为持续实施的战略提供信息.
相关概念视频
01:29Documentation in Long-Term and Home Healthcare Setting
992
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
992
01:28Drug Therapy
107
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
107
01:15Nursing Implementation
5.3K
Implementation is the execution of the nursing care plan developed during the planning phase.
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.
5.3K
01:15Methods of Documentation VI: Case Management Model
633
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
For example, a patient with a chronic...
633
01:19Pharmacovigilance
999
Post-marketing surveillance is a critical component of pharmaceutical regulation, often uncovering unanticipated adverse drug reactions (ADRs) once a drug is widely used over an extended period.
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
999
01:28Mitral Regurgitation IV: Nursing Management
90
Mitral regurgitation (MR) is a condition where the mitral valve does not close properly, leading to the backward flow of blood from the left ventricle into the left atrium during systole. This condition can arise from various causes, including rheumatic fever, infective endocarditis, or degenerative valve disease. Effective nursing management is crucial to optimizing patient outcomes and involves comprehensive assessment and targeted interventions.Comprehensive Patient AssessmentA detailed...
90