Lampen-Smith Alex, Young Janice, O'Rourke Mary-Anne, Balram Astuti, Inns Stephen
Department of Internal Medicine, Hutt Valley DHB, Lower Hutt, New Zealand.
N Z Med J. 2012 Feb 24;125(1350):30-6.
To evaluate whether the inclusion of advice in the hospital discharge letter regarding published guidelines for the review of PPI therapy can increase the number of patients that have documented PPI therapy review, consistent with the published guidelines, following hospital discharge.
Patients on PPIs at discharge from hospital were randomised to either have their hospital discharge letter completed as per usual practice or to have additional information on PPI review included that was aligned to published local guidelines. Patients' GP records were reviewed at 3 to 6 months post discharge to determine if a PPI review had occurred and if that review adhered to the guidelines.
Including specific, guideline based, PPI discharge instructions in the hospital discharge summary did not significantly increase the number of patients receiving post-discharge review consistent with the guidelines. Post discharge only 5/26 (19%) patients in the control group and 6/25 (24%) in the intervention group had their PPI therapy reviewed in accordance with the guidelines.
We were not able to demonstrate a beneficial change in PPI prescribing practice from the inclusion of PPI prescribing advice in the discharge letter.
评估在出院小结中纳入有关质子泵抑制剂(PPI)治疗复查的已发表指南的建议,是否能增加出院后有记录的、符合已发表指南的PPI治疗复查患者数量。
出院时正在使用PPI的患者被随机分为两组,一组按照常规做法完成出院小结,另一组在出院小结中纳入与当地已发表指南一致的有关PPI复查的额外信息。在出院后3至6个月对患者的全科医生记录进行审查,以确定是否进行了PPI复查以及该复查是否符合指南。
在出院小结中纳入基于指南的特定PPI出院指导,并未显著增加出院后接受符合指南复查的患者数量。出院后,对照组26名患者中只有5名(19%),干预组25名患者中只有6名(24%)的PPI治疗接受了符合指南的复查。
我们未能证明在出院小结中纳入PPI处方建议会使PPI处方实践产生有益变化。