摘要
目的建立门诊和居家患者药物相关问题(DRP)分类系统,为医务人员提供对DRP进行标准化记录的工具。方法检索国外数据库,收集现有DRP分类系统并进行遴选。对入选DRP分类系统进行比较分析,并结合我国门诊和居家患者药学服务工作特点进行整合,形成初始DRP分类系统。制作DRP分类系统专家咨询表,采用德尔菲法进行2轮专家咨询,根据专家意见进行修改和调整,形成终版DRP分类系统。结果经检索获得25个DRP分类系统,遴选出16个DRP分类系统进行整合,形成初始DRP分类系统。初始DRP分类系统的一级结构包含问题状态、问题类型、问题原因、问题干预和干预结果5个部分,每个部分有数量不等的条目,其中问题原因、问题干预和干预结果有数量不等的二级结构条目。第1轮咨询邀请32名专家,回收咨询表30份,回收率94%;第2轮咨询邀请30名专家,回收咨询表30份,回收率100%。经2轮咨询后,专家对一级结构中问题状态、问题类型、问题原因、问题干预和干预结果的认同率分别为100%、90%、83%、83%和97%。对于DRP分类系统中药物治疗适应证、有效性、安全性、经济性和依从性5类问题的评价,除经济性问题专家权威系数为0.79外,其他4类问题的专家权威系数均>0.8。第1、2轮咨询中专家意见协调系数分别为0.386(χ^(2)=995.258,P<0.001)和0.364(χ^(2)=971.232,P<0.001)。结合专家意见进行修改,形成包含一级结构条目5类共38个、二级结构条目3类共90个的终版DRP分类系统。结论初步建立了适合我国国情的门诊和居家患者DRP分类系统,可用作DRP的标准化记录工具。
Objective To establish a drug-related problems(DRPs)classification system for outpatients and home patients and provide healthcare staff with tools for standardized recording of DRPs.Methods DRPs classification systems-related literature were collected by searching foreign databases.The selected DRPs classification systems were compared and analyzed,and the initial DRPs classification system was formed by integrating the characteristics of pharmaceutical care for outpatients and home patients in China.The expert consultation form of DRPs classification system was made,expert consultation was performed for 2 rounds using Delphi method,and the final DRPs classification system was formed through modification and adjustment according to expert opinions.Results A total of 25 DRPs classification systems were obtained,of which 16 were selected and then integrated to form the initial version of the DRPs classification system.The primary structure of the initial DRPs classification system consisted of 5 parts:problem state,problem type,problem cause,problem intervention,and intervention result.Each part had different number of items,among which there were different number of secondary structure items in problem cause,problem intervention,and intervention result.In the first round of consultation,32 experts were invited and 30 consultation forms were collected,with a recovery rate of 94%.In the second round of consultation,30 experts were invited and 30 consultation forms were collected,with a recovery rate of 100%.After 2 rounds of consultation,the acceptance rates of experts for the question state,problem type,problem cause,question intervention,and intervention result in the primary structure were 100%,90%,83%,83%,and 97%,respectively.For the evaluation of 5 categories of drug treatment(indications,effectiveness,safety,economy,and compliance)in DRPs classification system,except for that the expert authority coefficient of economics was 0.79,the expert authority coefficient of the other 4 categories of issues was all>0.8.In the first and second round of consultation,the coordination coefficient of expert opinions was 0.386(χ^(2)=995.258,P<0.001)and 0.364(χ^(2)=971.232,P<0.001),respectively.After modifying with expert opinions,a final version of DRPs classification system was formed,which included 38 primary structure items in 5 categories and 90-secondary structure items in 3 categories.Conclusion A DRPs classification system for outpatients and home patients suitable for China′s national conditions has been initially established,which can be used as a standardized recording tool for DRP.
作者
刘清扬
白向荣
王可
苏甦
褚燕琦
曾艳
唐静
沈江华
张青霞
刘洋
杨军
王海莲
姜德春
闫素英
Liu Qingyang;Bai Xiangrong;Wang Ke;Su Su;Chu Yanqi;Zeng Yan;Tang Jing;Shen Jianghua;Zhang Qingxia;Liu Yang;Yang Jun;Wang Hailian;Jiang Dechun;Yan Suying(Department of Pharmacy,Xuanwu Hospital,Capital Medical University,National Clinical Research Center for Geriatric Disorders,Beijing 100053,China)
出处
《药物不良反应杂志》
CSCD
2021年第3期120-127,共8页
Adverse Drug Reactions Journal
基金
北京市科学技术委员会资助课题(D181100000218002)。
关键词
药物治疗管理
德尔菲技术
药物相关副作用和不良反应
药学服务
分类法
Medication therapy management
Delphi technique
Drug⁃related side effects and adverse reactions
Pharmaceutical services
Classification
