论文部分内容阅读
目的系统评价医生-护士-药师协作干预老年患者的治疗效果。方法计算机检索英文数据库:MEDLINE、EMbase、CENTRAL和中文数据库:中国知网、维普数据库和万方数据库,查找医生-护士-药师协作干预老年患者的随机对照试验,检索时限截至2015年3月。由2位研究者根据纳入与排除标准独立筛选文献、提取资料并评价质量后,采用Rev Man5.3.0版软件进行Meta分析。结果最终纳入RCT4个。结果显示:协作组与常规组住院率差异无统计学意义[RR=1.02,95%CI(0.93,1.11),P=0.69],急诊率差异无统计学意义[RR=0.97,95%CI(0.89,1.05),P=0.42],病死率差异无统计学意义[RR=1.03,95%CI(0.87,1.21),P=0.75]。对于改善潜在不合理用药比例,两组差异无统计学意义[RR=1.09,95%CI(0.84,1.41),P=0.51]。结论医生-护士-药师协作工作对于老年患者的结局指标比常规组没有较大益处,这可能与纳入文献数量有限有关。临床还需要继续探索更有效的医生-护士-药师协作诊疗工作。
Objective To systematically evaluate the effect of doctor-nurse-pharmacist collaborative intervention on elderly patients. Methods The computer-aided English-language databases were searched: MEDLINE, EMbase, CENTRAL and Chinese databases: CNKI, VIP database and Wanfang database to find a randomized controlled trial of physician-nurse-pharmacist intervening in elderly patients. The search period was up to March 2015. Two researchers independently screened the literature based on inclusion and exclusion criteria, extracted data, and assessed quality. Meta-analysis was performed using Rev Man 5.3.0 software. Results eventually included RCT 4 months. The results showed that there was no significant difference in the hospitalization rate between the two groups (RR = 1.02, 95% CI 0.93, 1.11, P = 0.69), and there was no significant difference in emergency rate between the two groups [RR = 0.97,95% CI 0.89, 1.05), P = 0.42]. There was no significant difference in case fatality rate (RR = 1.03, 95% CI 0.87, 1.21, P = 0.75). There was no significant difference between the two groups in improving the proportion of potentially unreasonable drug use [RR = 1.09, 95% CI (0.84, 1.41), P = 0.51]. Conclusion The collaborative work of doctor-nurse-pharmacist has no significant benefit on the outcomes of elderly patients than the conventional group, which may be related to the limited number of included literatures. Clinics also need to continue exploring more effective doctor-nurse-pharmacist collaborative work.