Structured pharmacist-led intervention programme to improve medication adherence in COPD patients: A randomized controlled study

Background

COPD is characterised by a progressive airflow limitation in the lungs. However, adherence to therapy improves management of symptoms and delays disease progression. Therefore, patients' knowledge and awareness about the disease are important. Hence, pharmacist-led educational interventions could achieve this and improve medication adherence.

药剂师主导的改善COPD患者用药依从性的干预研究（英文）

慢性阻塞性肺疾病(COPD)治疗的用药依从性与疾病控制相关。本文通过调查药剂师对干粉吸入剂(DPI)的使用进行干预后COPD患者吸入技术、满意度和依从性的改善情况,探讨使用干粉吸入剂患者的吸入技术、满意度与用药依从性之间的关系。研究对象为至少使用2个月DPIs的COPD患者,DPIs包括都宝(Turbohaler),准纳器(Discus)和吸乐(Handihaler)。当患者第一次进入研究时,吸入器技术、满意度和依从性等由训练有素的药剂师进行评估。第一次评估后,药剂师通过指导患者吸入剂使用,并针对患者用药满意度调查结果中不满意问题进行解答和干预,并对其进行1个月、3个月进行随访,6个月评估患者干预后吸入技术、满意度和依从性。共有135名患者完成本研究,患者吸入装置使用时间越长错误率越低,依从性越好,而CAT分越高及过去1年内病情加重次数越多,依从性越差。在干预前吸入技术中至少有一个错误的患者比例:都宝86.44%,准纳器76.60%,吸乐54.17%。药师干预后至少有一个错误的患者比例:都宝32.20%,准纳器29.79%,吸乐22.92%。干预后PASAPQ满意度平均分由基线时的74...     

Exploring the impact of pharmacist-led feedback on prescribing behaviour: A qualitative study

Background

Prescribing errors occur frequently in hospital settings. Interventions to influence prescribing behaviour are needed with feedback one potential intervention to improve prescribing practice. Doctors have reported a lack of feedback on their prescribing previously whilst the literature exploring the impact of feedback on prescribing behaviour is limited.

Lessons from a controlled evaluation of a general practice minimal intervention for problem drinking

A controlled evaluation of the Scottish Health Education Group's DRAMS Scheme in general practice failed to provide good evidence of the effectiveness of DRAMS compared with advice-only and non-intervention control groups, but also failed to provide an adequate test of DRAMS. Reasons for this are discussed and three kinds of lessons are drawn from the experience: lessons for future research into GP minimal interventions; lessons for the design of the interventions themselves; and, finally, lessons for strategies to be employed in the effort to engage the full interest and co-operation of general practitioners in working with problem drinkers.     

Early intervention in the general practice setting

There is a growing pressure on general practitioners to become more involved in the detection and management of alcohol related problems. However, there is evidence to suggest that general practitioners are unaware of the alcohol consumption of many of their patients, and even when they are aware that their patients are drinking too much, they are reluctant to manage these problems. This paper discusses some of the reasons why general practitioners avoid dealing with their heavy drinking patients. It is argued that advising patients to modify their alcohol consumption should be viewed as an exercise in health promotion, analogous to advising them to stop smoking or lose weight. The disease model of alcoholism, which is adhered to by many general practitioners, is seen as an impediment to the effective management of heavy drinkers within general practice.     

Supporting GPs to manage drug users in general practice: an evaluation of the substance misuse management project

Since 1982 in Britain, specialist reports and Government policy documents have encouraged the involvement of general practitioners (GPs) in the treatment of drug users. To date, and in spite of these policy initiatives, their involvement has been patchy and slow. This paper evaluates the work of the Brent and Harrow Health Authority, Substance Misuse Management Project (SMP), which was established in 1995 to facilitate GP treatment of problem drug users. The evaluation was designed as a cross sectional survey and gathered information from all GPs with whom the SMP were working, and who were treating opiate dependent drug users, and from the patients in receipt of that treatment. Three data collection instruments were employed for this purpose including a semi-structured interview schedule administered to the GPs; a structured survey form completed by the GPs for each patient they were currently treating for opiate dependency; and a patient satisfaction questionnaire. The findings support the conclusion that the SMP has been influential in facilitating the involvement of GPs in the care of drug users, and in maintaining their involvement. It is also apparent from the data that treatment is implemented in a considered and systematic way, which is congruent with patient need, and from which patients express high levels of satisfaction. Given the history of difficulties associated with the involvement of GPs in the treatment of problem drug users, the results from this study suggest that the SMP has found a workable solution. Their approach has been effective in Brent and Harrow and may have utility for other health authorities who wish to facilitate greater GP involvement in the care of problem drug users.     

A randomised trial of pharmacist-led discharge prescribing in an Australian geriatric evaluation and management service

International Journal of Clinical Pharmacy - Background Prescribing discharge medications is a potential “next step” for pharmacists in Australian hospitals, however, safety must be...     

A dual intervention in geriatric patients to prevent drug-related problems and improve discharge management

International Journal of Clinical Pharmacy - Background Drug-related problems (DRPs) endanger geriatric patients’ safety. Especially a follow-up treatment with increased number of care...