Introduction: Aging population is the main concern across countries. The demand for nursing homes (NH) is increasing due to this situation. The elderly are often with a phenomenon called polypharmacy, which will lead to serious drug-related problems. The rate of medication errors (ME) and adverse drug events (ADEs) is high in NH. Although there was much evidence reported the benefits of pharmaceutical care (PC), its introduction and development lagged behind in NH. The perceived need by key stakeholders is underreported. This study aimed to provide an overview of PC in NH, explore the need and potential barriers to the sustainable development of PC. Methods: This study consisted of two parts: systematic review and semi-structured interview to achieve its objectives. Results: There were 55 included studies in the systematic review. The main components of PC in NH included: medication review, education, and training, multidisciplinary team meetings. The most commonly reported output was the number of medications. Most of the studies assessed clinical outcomes. In the interview, 48 in- depth, semi-structured interviews were conducted. All participants perceived that PC offered benefits to medical staff and residents. The scope of PC consisted of management of pharmacy and inventory, dispensing, providing drug-related advice to support medical decisions and assist medication preparation, and providing basic drug knowledge to residents and their families. The most commonly observed benefits were decreased in medication errors, alleviated workload for frontline staff, raised awareness of drug-related problems, and promoted rational use of medicines. Barriers to PC development such as lack of pharmacy workforce and physical space, insufficient accessibility to residents’ medical records by pharmacists, ambiguous role descriptions of pharmacists, and absence of effective communication between NH and other healthcare institutes to keep track of the residents’ health conditions were identified in this study. Discussion: Previous studies have found that there are roles of pharmacists in NH, and the development of PC has a significant effect on improving the quality use of medicine in NH. Standardization of PC (including the level and firm of services and the mandate of pharmacy professionals) in NH is a key to generalize expectations from PC, monitor and evaluate the outcome, and develop evidence that supports sustainable PC development. Keywords: pharmaceutical care, nursing home, pharmacy professionals, key stakeholder

簡介:人口老齡化是各國關注的主要問題。基於這种情況，社會對安老院舍的需求正在增加。老年人常伴随著多重用藥的問題，這會導致嚴重的藥物相關問題。 安老院舍中用藥錯誤和藥物不良事件的發生率很高。儘管有許多證據證明了藥學服務的益處，但其在安老院舍的引入和發展滞後。主要利益相者的感知需求被低估了。本研究旨在概述安老院舍中藥學服務的情况，探討學服移可持續發展的必要性和潛在障礙。 方法:以實現上述提及的目的，本研究由系統回顧和半結構性訪談兩部分組成。 結果:系統評價共納入 55 項研究。安老院舍中學服務的主要組成部分包括:用藥審查、教育培訓、多學科團隊會議等。最常報告的輸出是藥物的數量。大多數研究著重評估臨床結果。在訪談中，進行了 48 個深度、半結構化的訪談。所有參與者都認為藥學服務為醫務人員和院友提供了好處。藥學服務的範圍包括藥房和庫存管理、配藥、提供與藥物相關的建議以支持醫療決策和協助準備藥物，以及為院友及其家人提供基本的藥物知。最多反映的用錯誤減少減輕了前線人員的工作量，提高了對藥物相關問題的認識和合理用藥。本研究亦發現缺乏藥學專業人員和藥房空間，較難取得院友的病歷報告，藥劑師的角色描述不明確和安老院舍與其他醫療機構之間缺乏有效的溝通來跟踪居民的健康狀況是現時藥學服務發展的主要障礙。 討論:已有研究發現，藥學專業人員在安老院舍扮演著重要的角色，藥學服務的發展對提高安老院舍中的用藥質量有顯著影響。標準化(包括服務的水平和機構以及藥學專業人員的職責)是概括對藥學服務的期望、監測和評估結果以及提供支持藥學服務可持續發展的證據的關鍵。 關鍵字:藥學服務、安老院舍、藥學專業人員、主要利益相關者