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Review Journal of clinical nursing. 2025 May 19. doi: 10.1111/jocn.17824 Q13.52024

Medication Management Services for Dialysis Patients: Impact on Clinical, Economic and Humanistic Outcomes-An Integrative Review

血液透析患者的药物管理服务:对临床、经济和人文结局的影响-整合回顾 翻译改进

Felice Fangie Leong  1, Siew Hoon Lim  1, Min Jia Wong  2, Nanthakumahrie Gunasegaran  1, Shin Yuh Ang  1, Fazila Aloweni  1

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作者单位

  • 1 Nursing Division, Singapore General Hospital, Singapore City, Singapore.
  • 2 Clinical Trials and Research Centre, Singapore city, Singapore.
  • DOI: 10.1111/jocn.17824 PMID: 40384514

    摘要 中英对照阅读

    Aim: To synthesise evidence on the types of Medication Management Services (MMS) and establish the effect of the different MMS interventions on Economic, Clinical and Humanistic Outcomes (ECHO) in dialysis patients.

    Design: Integrative review.

    Data sources: A systematic search was conducted from May to June 2024 using four databases: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library and Web of Science.

    Methods: This review followed Whittemore and Knafl's framework and adhered to the PRISMA 2020 statement: An updated guideline for reporting systematic reviews. Data extraction and quality assessment were independently conducted by three reviewers using the Joanna Briggs Institute Critical Appraisal Tool and the Quality Improvement Minimum Quality Criteria Set. Only English-language articles, primary and quality improvement studies were included, with no restrictions on publication date. Findings were narratively synthesised and thematically grouped by review aims.

    Results: A total of 14 articles were included. This review identified (1) the types of MMS provided to renal dialysis patients, and (2) the effects of these services on ECHO. Services varied in practices, including obtaining accurate medication histories, identifying discrepancies, reviewing laboratory results, making recommendations to prescribers, resolving issues based on collaborative agreements and providing patient education. These services were compared in terms of economic outcomes (e.g., 30-day readmission rates), clinical outcomes (e.g., medication discrepancies, MRPs, laboratory and clinical parameters) and humanistic outcomes (e.g., medication burden-related quality of life).

    Conclusion: This review highlighted various types of MMS available for dialysis patients and their impact on ECHO. Key benefits include recognising medication discrepancies, reducing MRPs, improving laboratory and clinical parameters, lowering 30-day readmission rates and enhancing medication burden-related quality of life. However, limitations such as retrospective studies, English-only publications and limited comparison across MMS models highlight the need for additional robust and diverse research.

    Reporting method: This integrative review was conducted in accordance with the PRISMA statement.

    Patient or public contribution: No Patient or Public Contribution.

    Keywords: adverse drug events; chronic kidney disease; clinical pharmacy services; medication reconciliation; medication review; medication safety; medication therapy management; patient‐reported outcomes; pharmaceutical care interventions; renal replacement therapy.

    Keywords:medication management services; dialysis patients; clinical outcomes; economic outcomes; humanistic outcomes

    目标:Aim: 汇总关于药物管理服务(MMS)的证据,确定不同 MMS 干预措施在透析患者中的经济、临床和人道主义结果(ECHO)的影响。

    设计:Design: 综合性回顾。

    数据来源:Data sources: 2024年5月至6月期间,使用PubMed、护理及相关健康文献累积索引(CINAHL)、Cochrane Library 和 Web of Science 四个数据库进行系统检索。

    方法:Methods: 该回顾遵循Whittemore和Knafl的框架,并遵守PRISMA 2020声明:关于报告系统性综述的最新指南。数据提取和质量评估由三位评审员独立进行,使用Joanna Briggs Institute批判性评价工具以及质量改进最低质量标准集。仅包括英文文献、原始研究及质量管理项目,不设出版日期限制。结果以叙述方式综合,并按照回顾目标主题分组。

    结果:Results: 共纳入14篇文章。此综述确定了(1)提供给肾透析患者的MMS类型;(2)这些服务对ECHO的影响。服务在实践中有所差异,包括获取准确的用药历史、识别不一致之处、审查实验室结果、向处方者提出建议、根据协作协议解决基于问题和进行患者教育等。这些服务以经济结果(如30天再入院率)、临床结果(例如药物不一致性、MRPs[可能是指药物相关问题],实验室及临床参数)以及人道主义结果(例如与用药负担相关的生命质量)等方面进行了比较。

    结论:Conclusion: 该综述强调了针对透析患者的多种MMS及其对ECHO的影响。关键益处包括识别药物不一致性、降低MRPs,改善实验室及临床参数,减少30天再入院率以及提高与用药负担相关的生命质量。然而,回顾性研究、仅限英文出版物和不同MMS模式之间有限的比较凸显了需要进一步进行稳健且多样化的研究。

    报告方法:Reporting method: 该综合性回顾按照PRISMA声明执行。

    患者或公众参与:Patient or public contribution: 没有患者或公众贡献。

    关键词:Keywords: 药物不良事件;慢性肾病;临床药学服务;用药核对;药物审查;药物安全性;药物治疗管理;患者报告结果;药品护理干预措施;肾脏替代疗法。

    关键词:药物管理服务; 血液透析患者; 临床结局; 经济结局; 人文结局

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    期刊名:Journal of clinical nursing

    缩写:J CLIN NURS

    ISSN:0962-1067

    e-ISSN:1365-2702

    IF/分区:3.5/Q1

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