Leemans L, Peeters M, Vanderheyden Ch, Dupont A G, Leys M, Saevels J, Sarre S, Steurbaut S, Verrydt A, Veroeveren L
Faculteit Geneeskunde en Farmacie VUB, Onderzoeksgroep Transmurale Zorg, Brussel.
J Pharm Belg. 2008 Dec;63(4):94-102.
To explore drug related problems a community pharmacist encounters when a patient is discharged from hospital. The study also investigates which information from the hospital reaches the community pharmacy.
A validated survey was presented, by community pharmacists, to patients or their family after hospital discharge, between the 1st of December 2007 and the 29th of February 2008. The survey contained questions on 4 items: patient characteristics--discharge medication--information received from the hospital--drug related problems and pharmacists interventions. Analyses were done with SPSS 16.0.
82 community pharmacists participated. 261 patients were included. Only 25% of the patients collected their medication from the pharmacy themselves. On discharge, patients on average received two additional drugs, compared to the pre-hospital situation. 69% received a medication chart, but less than half of them brought this chart along when visiting the pharmacy. Only 9% got computer-generated prescriptions from the hospital and < 3% received a letter of referral addressed to their pharmacist. In 33% of the cases the pharmacists noticed one or more problems concerning the medication prescribed after hospital discharge. The chance to detect a problem increased significantly when the chart was brought to the pharmacy (p=0.033). In case of observed problems, the community pharmacist succeeded to reach the treating specialist by phone in less than one third of those cases.
The results foster the discussion on the need for a better seamless care and the role clinical and community pharmacists could play in this care model.
探讨社区药剂师在患者出院时遇到的与药物相关的问题。该研究还调查了医院的哪些信息会传达至社区药房。
在2007年12月1日至2008年2月29日期间，社区药剂师在患者出院后向患者或其家属发放了一份经过验证的调查问卷。该调查问卷包含关于4个项目的问题：患者特征——出院用药——从医院获得的信息——药物相关问题及药剂师的干预措施。使用SPSS 16.0进行分析。
82名社区药剂师参与其中。纳入了261名患者。只有25%的患者亲自到药房取药。出院时，与住院前相比，患者平均多了两种药物。69%的患者收到了用药清单，但其中不到一半的人在去药房时带着这份清单。只有9%的患者从医院获得了计算机生成的处方，不到3%的患者收到了写给其药剂师的转诊信。在33%的案例中，药剂师注意到出院后所开药物存在一个或多个问题。当清单被带到药房时，发现问题的几率显著增加（p = 0.033）。在发现问题的情况下，社区药剂师在不到三分之一的案例中通过电话联系到了主治专家。
这些结果促进了关于改善无缝护理的必要性以及临床和社区药剂师在这种护理模式中可发挥的作用的讨论。
