Drug therapy - a challenge in primary care.

作者: Veronica Milos

DOI:

关键词: PharmacotherapyFamily medicineFocus groupTelecommunicationsMedical prescriptionMedicineIntervention (counseling)Patient safetyDrugQualitative researchPsychological intervention

摘要: Introduction: Drug therapy in primary care is a broad field, with two areas previously identified as particularly challenging: treatment of the elderly and prescription antibiotics against uncomplicated upper respiratory tract infections (URTIs). General practitioners’ (GPs’) attitudes adherence to evidence-based guidelines might be influenced by different interventions need studied. Objectives: 1. To study intervention models that influence GPs’ guidelines. 2. describe towards locally developed guidelines. Methods: (Paper I) Systematic medication reviews pharmacists were performed randomised controlled 369 patients living community or nursing homes, who using multi-dose drug dispensing (MDD) system. lists assessed before after focus on potentially inappropriate medications (PIMs). II) A retrospective analysis was conducted same patient sample, fall risk-increasing drugs (FRIDs), orthostatic (ODs) falls. III) questionnaire-based behaviour change aimed at reducing URTIs care. IV) qualitative group interviews assess local guidelines. Results: Papers I II: reduced number taking PIMs total these taking, but not more than three psychotropic drugs. significant proportion (87%) sample FRIDs ODs. Numbers associated severe There no association between numbers ODs occurrence Paper III: decrease antibiotic prescribing rate one groups compared control 0-6 years, differences all ages. IV: Trust recommendations safety found key factors prescribing, patient-doctor encounter, emphasis informing patient. The GPs experienced lack time self-inform, difficulties managing multiple prescribers direct-to-consumer industry information. Cost containment perceived both barrier motivator for guidelines. Conclusion: Multi-professional assessment patient’s list feasible methods improve quality studied further. trust essential prescribing.

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