门诊慢性病患者参与用药对用药安全性影响的系统评价

Effect of patient engagement on medication safety for chronic disease patients:a systematic review

目的系统评价门诊慢性病患者主动参与用药对用药安全性的影响。方法计算机检索PubMed、EMBASE、The Cochrane Library及中国知网、维普网、万方全文数据库自建库至2022年7月关于促进患者参与提升用药安全的随机对照试验研究,根据纳入和排除标准筛选文献,对纳入文献进行资料提取和质量评价。结果共纳入15篇文献,研究发生在门诊和居家环境,研究对象为慢性病患者。干预内容分为3种:患者参与用药方案制定、患者参与用药方案调整、患者参与日常用药管理。纳入的用药安全主要结果指标为用药依从性、用药知识、用药信念、不良事件发生、用药差错。患者主动参与用药安全的干预策略提升了患者的用药知识,但未显著改善用药依从性。结论促进患者参与用药可提高患者对用药安全的认知。受纳入研究数量和质量的限制,尚待更多高质量研究予以验证。

Objective To explore the effect of patient engagement on medication safety for patients with chronic disease through a systematic review.Methods Relevant randomized controlled trials of patient engagement on medication safety were searched from PubMed,EMBASE,The Cochrane Library,CNKI,Wanfang and VIP database.The literature was screened according to inclusion and exclusion criteria,and data extraction and literature quality evaluation was conducted on the selected literature.Results A total of 15 eligible studies was included.Most of the studies occurred in outpatient and home settings,and the subjects were patients with chronic diseases.Patient engagement strategies can be divided into three categories:(1)patient engagement in medical decision-making;(2)patient engagement in medication adjustment;(3)patient engagement in medication management.The outcomes of medication safety included medication adherence,medication knowledge,medication beliefs,adverse events and medication errors.Intervention strategies for patients to actively engage in medication safety significantly improved patients′medication knowledge and beliefs,but did not improve medication adherence of patients.Conclusion Promoting patient active engagement is an effective intervention measure to improve patients′perception of medication safety.Due to the limited quality and quantity of the included studies,more high-quality studies are needed to verify the above conclusions.