Lindberg Magnus, Lindberg Per, Wikström Björn
Centre for Research and Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden.
Scand J Urol Nephrol. 2007;41(6):546-52. doi: 10.1080/00365590701421363.
Extensive drug utilization, and non-concordance between the patient and the caregiver about prescriptions and actual medicine intake, are associated with the risk of non-adherence to medication as well as medication-related illness. To achieve reliable estimates of drug use, it is important to consider the patient's self-reported drug utilization as well as to consult his/her medical record. The present multicentre study was conducted with the aim of examining the self-reported drug consumption of dialysis patients and its congruence with medical records.
Consumption of pharmaceutical agents was recorded by 204 patients undergoing haemo- or peritoneal dialysis at 10 Swedish clinics. Drug record discrepancies were identified by comparing the self-reported use of prescribed medicines with the subsequently obtained medication lists.
The median drug intake was 11 prescribed medicines and by including on-demand drugs this increased to 12. Discrepancies between the self-reported use of prescribed drugs and the medical record were prevalent in 80.4% of cases, with a median of three discrepancies per patient.
Dialysis patients have an extensive need for medication but there is an undesirable deviation between consumption and prescription. A single medication list, accessible for the patient and for all prescribers, is a possible solution to achieve concordance but other measures, such as analysis of the reasons for discrepancy and tailored measures, would also benefit concordant medicine-taking.
大量的药物使用以及患者与护理人员在处方和实际用药方面的不一致，与不遵医嘱用药的风险以及药物相关疾病有关。为了获得可靠的药物使用估计值，考虑患者自我报告的药物使用情况并查阅其病历很重要。本多中心研究旨在调查透析患者自我报告的药物消费情况及其与病历的一致性。
瑞典10家诊所的204名接受血液透析或腹膜透析的患者记录了药物使用情况。通过比较自我报告的处方药使用情况与随后获得的用药清单来确定药物记录差异。
药物摄入中位数为11种处方药，若包括按需使用的药物则增至12种。80.4%的病例中，自我报告的处方药使用情况与病历之间存在差异，每位患者差异的中位数为3处。
透析患者对药物有大量需求，但用药与处方之间存在不理想的偏差。为患者和所有开处方者提供一份单一的用药清单，可能是实现一致性的一种解决方案，但其他措施，如分析差异原因和采取针对性措施，也将有助于实现一致用药。
