德国东北部药房急性腹泻咨询的评估-一项使用模拟患者方法的随访研究

Bernhard Langer, Michael Kieper, S. Laube, J. Schramm, Sophia J. Weber, Alexander Werwath
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引用次数: 10

摘要

目的:作为本研究的主要目的,我们分析了2014年(基线研究)至2017年(后续研究)期间药房提供的建议质量是否可以通过2014年向每家药房提供的单一书面绩效反馈来实际提高。随访检查的第二个目的是分析建议的质量是否因提供建议的专业团体而异。方法学:为确保基线研究与随访研究比较中尽可能少的失真,2017年随访研究采用的研究设计与2014年基线研究相比没有改变。因此,后续检查的数据是在德国东北部一个城市的所有21家药店中使用模拟患者方法收集的。三名女性和两名男性测试购买者在所有药房使用四种不同的方案自行治疗急性腹泻(总共购买了84次测试)。结果:基线研究(2014年)与随访研究(2017年)的总体结果存在显著差异(Wilcoxon sign rank检验;Z = -2.065, p = 0.039, r = 0.225)。整体平均而言,药房在2017年仅获得2.7分(30%),而2014年则达到3.3分(37%)。各专业群体的咨询质量差异无统计学意义(Kruskal-Wallis检验:χ2(2) = 1.946;P = 0.378, r = 0.027)。结论:成人急性腹泻的建议质量随着时间的推移而下降。一份旨在提高质量的书面绩效反馈被证明无效。要提高所提供咨询的质量,就需要具有更大影响的干预措施。
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Assessment of Counselling for Acute Diarrhoea in North-Eastern German Pharmacies—A Follow-Up Study Using the Simulated Patient Methodology
Aim: As the primary aim of this study, we analysed whether the quality of advice provided by pharmacies in the period between 2014 (baseline study) and 2017 (follow-up study) could actually be increased using a single written performance feedback given to each pharmacy in 2014. The secondary aim of the follow-up examination was to analyse whether the quality of advice differed depending on the professional group providing the advice. Methodology: To ensure the least possible distortion in the comparison between the baseline and the follow-up studies, the study design used for the follow-up examination in 2017 was not changed compared to the baseline examination in 2014. The data for the follow-up examination were therefore collected using the simulated patient method in all 21 pharmacies in a city in the north-east of Germany. Three female and two male test buyers used four different scenarios for self-medication of acute diarrhoea in all of the pharmacies (a total of 84 test purchases). Results: There were significant differences between the overall results from the baseline study (2014) and the follow-up study (2017) (Wilcoxon signed rank test; z = –2.065, p = 0.039, r = 0.225). In the overall average, the pharmacies in 2017 achieved only 2.7 (30%) of 9 possible points whereas in 2014 they achieved 3.3 (37%). The quality of advice between the professional groups did not show any significant differences (Kruskal-Wallis test: χ2(2) = 1.946; p = 0.378, r = 0.027). Conclusions: The quality of advice for acute diarrhoea in adults declined over time. A written performance feedback intended to improve the quality proved ineffective. Interventions with a far greater impact are required to achieve an improvement in the quality of advice provided.
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