Foulon V, Claeys C, De Lepeleire J, Chevalier P, Desplenter F, De Winter S, Dumont C, Lacour V, Simoens S, Dubois C, Paulus D, Spinewine A
Katholieke Universiteit Leuven, Research Centre for Pharmaceutical Care and Pharmaco-economics.
J Pharm Belg. 2010 Dec(4):105-9.
The continuity of pharmacotherapy is of vital importance when patients move from one health care setting to another. Unfortunately, this continuity is not always guaranteed. The aim of this study is to propose solutions to enhance the continuity of pharmacotherapy at hospital admission and discharge. The study consists of a systematic review of the international literature and an analysis of seamless care initiatives in seven selected countries; a summary of Belgian data on problems as well as solutions with regard to continuity of care; a quantification of the extent of medication changes as a result of a hospital stay in Belgium; and a qualitative analysis of the perception of Belgian health care professionals (HCPs) on approaches to improve seamless care. The literature review yielded 15 papers of sufficient quality. However, this review did not generate definitive conclusions on the clinical impact and the cost-effectiveness of interventions aiming to enhance the continuity of pharmacotherapy. The most important initiatives that have been put in practice in foreign countries include the development and implementation of guidelines for HCPs; national information campaigns; education of HCPs; and the development of information technologies as to share patient and prescription data between settings of care. For Belgium, 66 seamless care initiatives were identified. The high number and variety of projects show the interest for this topic as well as the involvement of various HCPs from diverse settings in the development of solutions. Based on this research, and the solutions discussed in the focus groups, the following elements are proposed to enhance the continuity of pharmacotherapy: a national guideline governing the continuity of pharmacotherapy; a national campaign to sensitize HCPs and patients in this area; the availability of a comprehensive and up to date medication list for each patient; and electronic healthcare infrastructure that facilitates sharing of information.
当患者从一个医疗环境转移到另一个医疗环境时，药物治疗的连续性至关重要。不幸的是，这种连续性并非总能得到保证。本研究的目的是提出解决方案，以加强住院和出院时药物治疗的连续性。该研究包括对国际文献的系统综述以及对七个选定国家无缝护理举措的分析；对比利时关于护理连续性问题及解决方案的数据总结；对比利时住院导致的用药变化程度的量化；以及对比利时医疗保健专业人员（HCPs）对改善无缝护理方法的看法的定性分析。文献综述产生了15篇质量足够的论文。然而，该综述并未就旨在加强药物治疗连续性的干预措施的临床影响和成本效益得出明确结论。国外实施的最重要举措包括为HCPs制定和实施指南；全国宣传活动；对HCPs的教育；以及开发信息技术以在不同护理环境之间共享患者和处方数据。对比利时而言，确定了66项无缝护理举措。项目的数量众多且种类繁多，表明对该主题的兴趣以及不同环境中的各种HCPs参与了解决方案的制定。基于这项研究以及焦点小组讨论的解决方案，提出以下要素以加强药物治疗的连续性：一项管理药物治疗连续性的国家指南；一项在该领域提高HCPs和患者认识的全国性活动；为每位患者提供全面且最新的用药清单；以及便于信息共享的电子医疗基础设施。
