%0期刊文章@ 14388871% I JMIR出版公司V 15% 卡塔尔世界杯8强波胆分析N 12% P e264% T对齐药物和解和安全消息:初级保健提供者观点的定性研究%A Heyworth,Leonie Clark,Justice Marcello,Thomas B %A Paquin,Allison M %A Stewart,Max A Archambeault,Cliona A Simon,Steven R +退伍军人事务波士顿医疗保健系统，普通内科科，150 South Huntington Ave, Mailstop 152G, Boston, MA, 02130，美国，1 617 826 5319,lheyworth@gmail.com %K药物协调%K安全消息%K安全电子邮件，初级保健提供者经历%K健康信息技术(HIT) %D 2013 %7 02.12.2013 %9原始论文%J J医疗互联网Res %G英文%X背景:虚拟(非面对面)药物协调策略可以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。在扎根理论的指导下进行内容分析。结果:在15个参与的提供者中，12个是女性，11个在一个典型的工作日看到10个或更少的患者。在深度访谈中，从提供者那里获得的经验和看法被组织成12个总体主题:4个主题是药物和解的经验，3个主题是关于如何改善门诊药物和解的看法，5个主题是关于SM的经验。 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. %M 24297865 %R 10.2196/jmir.2793 %U //www.mybigtv.com/2013/12/e264/ %U https://doi.org/10.2196/jmir.2793 %U http://www.ncbi.nlm.nih.gov/pubmed/24297865