药剂师主导的新药服务:荷兰的一项现实世界队列研究,研究对象是向初级保健过渡的心血管患者的药物相关问题、满意度和自我效能感。

IF 2.6 4区 医学 Q2 PHARMACOLOGY & PHARMACY International Journal of Clinical Pharmacy Pub Date : 2024-12-10 DOI:10.1007/s11096-024-01829-4
Hendrik T Ensing, Nelly Kurt, Ruby A Janssen, Ellen S Koster, Eibert R Heerdink
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引用次数: 0

摘要

背景:患者从医院转到家庭,同时开始长期心血管药物治疗可能会遇到药物相关问题(DRPs)。新药服务(NMS)可以支持初级保健的再入院。目的:评估在现实世界中,从医院转到初级保健的新开心血管药物的患者在识别DRPs、患者对药物信息的满意度和患者自我效能感方面的NMS。次要目标是确定drp的危险因素和评估首次用药停药。方法:在荷兰Almere的一家门诊药房和14家社区药房进行队列研究,纳入≥18年接受心血管新处方的患者。通常的药房护理在配药后两周内辅以电话咨询,以确定和处理drp。在随访电话中评估患者满意度和自我效能。使用配药数据测量首次补药停药,并通过逻辑回归确定DRPs的危险因素。结果:在1647例符合条件的患者中,743例接受了NMS;72.5%经历了≥1次DRP。结论:在现实世界的过渡性护理环境中实施NMS使药师能够识别drp并提供适合患者需求的咨询。患者对信息的满意度更高,自我效能也有所提高。应优先考虑高危患者进行DRPs,并部署其他药房工作人员执行NMS。
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Pharmacist-led new medicine service: a real-world cohort study in the Netherlands on drug-related problems, satisfaction, and self-efficacy in cardiovascular patients transitioning to primary care.

Background: Patients transitioning from hospital to home while starting long-term cardiovascular medicines are likely to experience drug-related problems (DRPs). The New Medicine Service (NMS) may support readmission to primary care.

Aim: To evaluate NMS in a real world setting, for patients transitioning from hospital to primary care with newly prescribed cardiovascular medicines on identifying DRPs, patient satisfaction with medication information and patient self-efficacy. Secondary objectives were identifying risk factors for DRPs and assessing first-fill discontinuation.

Method: A cohort study in an outpatient pharmacy and 14 community pharmacies in Almere, the Netherlands, involved patients ≥ 18 years receiving new cardiovascular prescriptions. Usual pharmacy care was complemented with a telephone counselling two weeks post-dispensing to identify and address DRPs. Patient satisfaction and self-efficacy were assessed during a follow-up call. First-fill discontinuation was measured using dispensing data, and logistic regression identified risk factors for DRPs.

Results: Of 1647 eligible patients, 743 received NMS; 72.5% experienced ≥ 1 DRP. NMS improved patients' satisfaction with information and self-efficacy (p < 0.001). Outpatient visits (adj. OR 0.64), cardiovascular medicine use (adj. OR 0.65), and use of chronic medicines (adj. OR 1.71) influenced DRPs. First-fill discontinuation remained unchanged post-NMS, but patients with DRPs discontinued more often (14.8% vs. 8.6%, p = 0.030).

Conclusion: Implementing the NMS in a real-world transitional care setting allowed pharmacists to identify DRPs and provide counselling tailored to patient needs. Patients reported higher satisfaction with information and increased self-efficacy. Priority should be given to at-risk patients for DRPs, and deploy other pharmacy staff to perform the NMS.

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来源期刊
CiteScore
4.10
自引率
8.30%
发文量
131
审稿时长
4-8 weeks
期刊介绍: The International Journal of Clinical Pharmacy (IJCP) offers a platform for articles on research in Clinical Pharmacy, Pharmaceutical Care and related practice-oriented subjects in the pharmaceutical sciences. IJCP is a bi-monthly, international, peer-reviewed journal that publishes original research data, new ideas and discussions on pharmacotherapy and outcome research, clinical pharmacy, pharmacoepidemiology, pharmacoeconomics, the clinical use of medicines, medical devices and laboratory tests, information on medicines and medical devices information, pharmacy services research, medication management, other clinical aspects of pharmacy. IJCP publishes original Research articles, Review articles , Short research reports, Commentaries, book reviews, and Letters to the Editor. International Journal of Clinical Pharmacy is affiliated with the European Society of Clinical Pharmacy (ESCP). ESCP promotes practice and research in Clinical Pharmacy, especially in Europe. The general aim of the society is to advance education, practice and research in Clinical Pharmacy . Until 2010 the journal was called Pharmacy World & Science.
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