实施跨专业药物护理计划:从基层医疗机构自下而上的成功举措中汲取的经验。

IF 2.6 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES International Journal of Integrated Care Pub Date : 2024-04-09 eCollection Date: 2024-04-01 DOI:10.5334/ijic.7581
Indira Coenen, Elyne De Baetselier, Veerle Foulon, Tinne Dilles
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引用次数: 0

摘要

导言:尽管有证据表明,跨专业、以人为本的综合护理对于优化患有多种药物的老年人的药物护理非常重要,但这种工作方式在实践中却往往无法实施。本研究的目的是找出成功的跨专业举措的共同特点以及影响其实施的因素,以缩小这种认识上的差距:方法:采用半结构式深度访谈的定性探索设计。访谈对象包括弗拉芒初级医疗保健专业人员(HCPs)和 75 岁以上的患者,他们都参与了为患有多种药物的老年人提供跨专业药物护理的成功项目。通过归纳分析确定了主要议题:结果:15 名保健医生和 4 名病人接受了访谈,他们参与了 9 项跨专业活动。在所有活动中,高级保健人员都就老年人的多重用药问题进行了跨专业咨询。倡议的特点与背景之间的相互作用对实施产生了重要影响。这些背景因素可分为微观背景、中观背景和宏观背景。实施策略,即促进倡议采纳的行动,与三个主题相对应:沟通和影响、不同利益相关者的协调以及(不)激励:这些成功因素的确定可能会激励保健医生、跨专业教育提供者和政策制定者促进跨专业药物护理。
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Implementation of Interprofessional Pharmaceutical Care Initiatives: Lessons Learned from Successful Bottom-Up Initiatives in Primary Care.

Introduction: Although there is evidence that interprofessional, person-centred, integrated care is important for optimising pharmaceutical care of older people with polypharmacy, this way of working is often not implemented in practice. The aim of this study was to identify common characteristics of successful interprofessional initiatives and factors influencing their implementation, in order to close this know-do gap.

Methods: A qualitative, explorative design with in-depth semi-structured interviews was used. Flemish primary healthcare professionals (HCPs) and patients aged over 75, involved in successful initiatives of interprofessional pharmaceutical care for older people with polypharmacy, were included. Inductive analysis was conducted to identify main topics.

Results: Fifteen HCPs and four patients, involved in nine interprofessional initiatives, were interviewed. In all initiatives the HCPs had interprofessional consultations about older people with polypharmacy. The interaction between the characteristics of the initiatives and the context had an important impact on the implementation. These context factors were positioned under the micro-, meso- and macro context. Implementation strategies, actions to enhance the initiatives' adoption, corresponded with three themes: communication and influence, coordination by different stakeholders, and (dis)incentives.

Conclusion: The identification of these success factors might inspire HCPs, providers of interprofessional education and policymakers to facilitate interprofessional pharmaceutical care.

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来源期刊
International Journal of Integrated Care
International Journal of Integrated Care HEALTH CARE SCIENCES & SERVICES-
CiteScore
3.80
自引率
8.30%
发文量
887
审稿时长
>12 weeks
期刊介绍: Established in 2000, IJIC’s mission is to promote integrated care as a scientific discipline. IJIC’s primary purpose is to examine critically the policy and practice of integrated care and whether and how this has impacted on quality-of-care, user experiences, and cost-effectiveness. The journal regularly publishes conference supplements and special themed editions. To find out more contact Managing Editor, Susan Royer. The Journal is supported by the International Foundation for Integrated Care (IFIC).
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