实施医院描述行为改变干预和进行试验流程的可行性:混合方法评估
Sion Scott1, Jacqueline Martin-Kerry1, Megan Pritchard2
1School of Healthcare, University of Leicester, Leicester, UK.
Research in social & administrative pharmacy : RSAP
|November 30, 2025
概括
由老年科医生领导的综合药物审查 (CHARMER) 干预措施是可行的,用于医院的抑郁症. 90天的再入院率是对未来试验最合适的初级结果衡量标准.
科学领域:
- 老年医学 老年医学
- 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:
- 由老年医师领导的综合药物审查 (CHARMER) 是针对老年医生和药剂师的行为干预,以改善医院的抑郁症处方实践.
- CHARMER包括一个行动计划,教育材料和一个绩效仪表板,以促进药物审查和停止处方.
研究的目的:
- 评估对CHARMER干预进行最终试验的可行性.
- 为了确定一个CHARMER试验最合适的初级结果指标:90天的住院再入院或患者的生活质量 (QoL).
主要方法:
- 在四家医院进行了双臂可行性研究,其中三个接受了CHARMER干预,一个作为对照.
- 干预的真实性,可接受性和数据完整性通过过程评估进行评估,包括与医疗保健工作人员和患者的采访.
主要成果:
- 在18名老年医生和药剂师中,CHARMER干预措施以可接受的忠诚度实施,招募了318名患者.
- 有91.2%的患者可获得90天的住院再接收数据,而只有37.9%的接触患者同意使用QoL措施,52%完成了随访.
结论:
- 在医院环境中实施CHARMER干预是可行的.
- 建议将90天的再入院率作为主要结果指标,因为数据完整性比患者生活质量指标更高.
- 需要对实施指南进行轻微调整,以解决医院特定的挑战,包括行动计划和仪表板的使用.
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