背景:药物审查实践在国际上已经朝着不仅医生而且其他医疗保健专业人员根据商定的实践进行药物审查的方向发展。合作做法日益凸显需要建立电子联合平台,以记录药物治疗方案及其实施情况的信息,保持更新,和分享。
目的:本研究的目的是协调药物审查的定义,并为电子病历中的协作实施和文档创建统一的概念基础(定义名称:协作药物审查)。
方法:该研究是在2020年9月至12月与三个跨专业专家小组进行的Delphi共识调查中进行的。共识率为80%。专家根据国际和国家药物审查定义清单评估了合作药物审查的拟议定义。专家小组(n=41)涉及12名医生,13名药剂师,10名护士,和六名信息管理专业人员。各轮的应答率范围为63-88%。
结果:专家们评论了哪些具有药物审查特征的预选项目(n=75)应包含在协作药物审查的定义中。这些项目分为以下五个主题,其中51个达成共识:1)合作药物审查中包括的行动(n=24/24),2)应进行审核的设置(n=5/5),3)应根据需要考虑并进行审查的情况(n=10/11),4)优先考虑审查要实现的前五名益处,5)优先考虑审查应针对的前五名患者群体。
结论:在协作药物审查的定义上达成了强烈的跨专业共识。最具挑战性的是确定受益于审查的个体患者群体。
BACKGROUND: Medication review practices have evolved internationally in a direction in which not only physicians but also other healthcare professionals conduct medication reviews according to agreed practices. Collaborative practices have increasingly highlighted the need for electronic joint platforms where information on medication regimens and their implementation can be documented, kept updated, and shared.
OBJECTIVE: The aim of this study was to harmonize the definition of medication reviews and create a unified conceptual basis for their collaborative implementation and documentation in electronic patient records (definition appellation: collaborative medication review).
METHODS: The study was conducted using the Delphi
consensus survey with three interprofessional expert panel rounds in September-December 2020. The
consensus rate was set at 80%. Experts assessed the proposed definition of collaborative medication review based on an international and national inventory of medication review definitions. The expert panel (n = 41) involved 12 physicians, 13 pharmacists, 10 nurses, and six information management professionals. The range of response rates for the rounds was 63-88%.
RESULTS: The experts commented on which of the pre-selected items (n = 75) characterizing medication reviews should be included in the definition of collaborative medication review. The items were divided into the following five themes and 51 of them reached
consensus: 1) Actions included in the collaborative medication review (n = 24/24), 2) Settings where the review should be conducted (n = 5/5), 3) Situations where the review should be considered as needed and carried out (n = 10/11), 4) Prioritization of top five benefits to be achieved by the review and 5) Prioritization of top five patient groups to whom the review should be targeted.
CONCLUSIONS: A strong interprofessional
consensus was reached on the definition of collaborative medication review. The most challenging was to identify individual patient groups benefiting from the review.