Johnston Rochelle, Saulnier Lauza, Gould Odette
, BScPharm, ACPR, is with the Pharmacy Department, Horizon Health Network, Zone 1 Moncton, Moncton, New Brunswick.
Can J Hosp Pharm. 2010 Sep;63(5):359-65. doi: 10.4212/cjhp.v63i5.947.
Obtaining an accurate and complete medication list (i.e., the best possible medication history [BPMH]) is the first step in completing medication reconciliation. The ability of pharmacy technicians to obtain medication histories, relative to that of pharmacists, has not been formally assessed.
To determine whether pharmacy technicians at the authors' institution could obtain a BPMH as accurately and completely as pharmacists and if both groups met national norms for unintentional discrepancies and the success index for medication reconciliation.
Pharmacy technicians were trained in obtaining a BPMH at the beginning of the study, before any patients were enrolled. Patients presenting to the emergency department were prospectively enrolled to be interviewed separately by both a pharmacist and a technician, with information recorded on standard medication reconciliation forms. The completed forms for each patient were compared following each set of interviews, and discrepancies were clarified with the patient.
Fifty-nine patients were included in the study, and 3 pharmacists and 2 technicians obtained the histories. There was no significant difference between pharmacists and technicians in terms of discrepancies involving prescription drugs (χ(2) = 0.52, df = 1, n = 118, p = 0.47, Cramer's V for effect size = 0.07) or over-the-counter medications (χ(2) = 0.09, df = 1, n = 118, p = 0.77, Cramer's V = 0.03). The mean number of discrepancies per patient did not differ significantly between the pharmacists and technicians (t = 0.15, df = 58, p = 0.88 for prescription drugs; t = -0.22, df = 58, p = 0.83 for over-the-counter products). For both groups, the number of unintentional discrepancies per patient was significantly lower and the success index for medication reconciliation significantly higher than the national average.
Trained pharmacy technicians at the authors' institution were able to obtain a BPMH with as much accuracy and completeness as pharmacists. Both groups were significantly superior to the national average in terms of unintentional discrepancies and success index for medication reconciliation.
获取准确完整的用药清单（即尽可能完善的用药史[BPMH]）是完成用药核对的第一步。相对于药剂师，药房技术员获取用药史的能力尚未得到正式评估。
确定作者所在机构的药房技术员能否像药剂师一样准确完整地获取BPMH，以及两组是否符合无意差异的国家规范和用药核对的成功指数。
在研究开始时，在纳入任何患者之前，对药房技术员进行获取BPMH的培训。前瞻性纳入到急诊科就诊的患者，由药剂师和技术员分别对其进行访谈，并将信息记录在标准用药核对表格上。每组访谈后，对每位患者填写完整的表格进行比较，如有差异则与患者核实。
59名患者纳入研究，3名药剂师和2名技术员获取了用药史。在涉及处方药的差异方面（χ(2)=0.52，自由度=1，n=118，p=0.47，效应量的克莱默V值=0.07）或非处方药方面（χ(2)=0.09，自由度=1，n=118，p=0.77，克莱默V值=0.03），药剂师和技术员之间无显著差异。每位患者的差异平均数在药剂师和技术员之间也无显著差异（处方药：t=0.15，自由度=58，p=0.88；非处方药：t=-0.22，自由度=58，p=0.83）。对于两组而言每位患者的无意差异数量均显著低于全国平均水平，用药核对的成功指数显著高于全国平均水平。
作者所在机构经过培训的药房技术员能够像药剂师一样准确完整地获取BPMH。在无意差异和用药核对成功指数方面，两组均显著优于全国平均水平。
