@Article{信息:doi 10.2196 / / jmir。2793，作者=“Heyworth, Leonie和Clark, Justice和Marcello, Thomas B和Paquin, Allison M和Stewart, Max和Archambeault, Cliona和Simon, Steven R”，标题=“调整药物和解和安全消息:初级保健提供者视角的定性研究”，期刊=“J医学互联网研究”，年=“2013”，月=“12”，日=“02”，卷=“15”，数=“12”，页=“e264”，关键词=“药物和解;安全信息;安全电子邮件，初级保健;供应商经验;背景:虚拟(非面对面)药物和解策略可能减少弱势门诊患者的药物不良事件(ADEs)。了解提供者对使用药物调节技术的观点可以为以患者为中心的解决方案的设计提供信息，以提高门诊用药的安全性。目的:本研究的目的是描述初级保健提供者在门诊药物调节和安全信息(患者和提供者之间的安全电子邮件)方面的经验，并引出使用安全信息(SM)的虚拟药物调节系统的看法。方法:采用半结构化访谈法进行定性研究。从2012年1月到2012年5月，我们对初级保健临床活动进行了结构化观察，并采访了美国马萨诸塞州波士顿退伍军人事务医疗保健系统内的15名初级保健提供者。 We carried out content analysis informed by the grounded theory. Results: Of the 15 participating providers, 12 were female and 11 saw 10 or fewer patients in a typical workday. Experiences and perceptions elicited from providers during in-depth interviews were organized into 12 overarching themes: 4 themes for experiences with medication reconciliation, 3 themes for perceptions on how to improve ambulatory medication reconciliation, and 5 themes for experiences with SM. Providers generally recognized medication reconciliation as a valuable component of primary care delivery and all agreed that medication reconciliation following hospital discharge is a key priority. Most providers favored delegating the responsibility for medication reconciliation to another member of the staff, such as a nurse or a pharmacist. The 4 themes related to ambulatory medication reconciliation were (1) the approach to complex patients, (2) the effectiveness of medication reconciliation in preventing ADEs, (3) challenges to completing medication reconciliation, and (4) medication reconciliation during transitions of care. Specifically, providers emphasized the importance of medication reconciliation at the post-hospital visit. Providers indicated that assistance from a caregiver (eg, a family member) for medication reconciliation was helpful for complex or elderly patients and that patients' social or cognitive factors often made medication reconciliation challenging. Regarding providers' use of SM, about half reported using SM frequently, but all felt that it improved their clinical workflow and nearly all providers were enthusiastic about a virtual medication reconciliation system, such as one using SM. All providers thought that such a system could reduce ADEs. Conclusions: Although providers recognize the importance and value of ambulatory medication reconciliation, various factors make it difficult to execute this task effectively, particularly among complex or elderly patients and patients with complicated social circumstances. Many providers favor enlisting the support of pharmacists or nurses to perform medication reconciliation in the outpatient setting. In general, providers are enthusiastic about the prospect of using secure messaging for medication reconciliation, particularly during transitions of care, and believe a system of virtual medication reconciliation could reduce ADEs. ", issn="14388871", doi="10.2196/jmir.2793", url="//www.mybigtv.com/2013/12/e264/", url="https://doi.org/10.2196/jmir.2793", url="http://www.ncbi.nlm.nih.gov/pubmed/24297865" }