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一项前后对照研究,以评估一种患者与医疗专业人员合作模式对有效药物重整的作用。

A controlled before and after study to evaluate a patient and health professional partnership model towards effective medication reconciliation.

作者信息

Lingaratnam Senthil, Aranda Sanchia, Pearce Tracy, Kirsa Sue

机构信息

Pharmacy Department, Peter MacCallum Cancer Centre, Australia.

出版信息

J Oncol Pharm Pract. 2013 Mar;19(1):48-56. doi: 10.1177/1078155212451936. Epub 2012 Jul 30.

Abstract

UNLABELLED

Preventable medication errors impact substantially on the Australian healthcare system. Where 'poor communication of medical information at transition points is responsible for as many as 50% of all medication errors', a leading contributor for this type of medication error is lack of consumer knowledge about medicines information. This study was aimed at designing and testing the effectiveness of a consumer-healthcare professional partnership model towards effective medication reconciliation. This model aims to empower consumers about their medicines information, so that they would contribute more effectively to medication reconciliation and thereby minimise medication errors occurring at transition points. Components of this model were informed by qualitative data gleaned from patient opinion surveys, focus group sessions involving nurses, doctors and pharmacists working at the hospital and results of a literature search of medication safety tools. Programme development was informed by health improvement approaches centred on a Plan-Do-Study-Act cycle. Evaluation for effectiveness was conducted within a framework of a controlled before and after study.

RESULTS

revealed that there was a 1.4-fold increase in the reporting rate of pharmacists intervention. The study could not demonstrate that the designed intervention was effective in minimising near-misses. However, there is statistically insignificant reduction in errors for patients that were correctly exposed to the intervention. Anecdotal evidence suggests there is utility for a patient population keen to claim greater ownership of their medicines information. Further, we advocate that patient education about medicines and the establishment of a consumer-healthcare professional model occur prior to ward admission.

摘要

未标注

可预防的用药错误对澳大利亚医疗系统造成了重大影响。由于“在交接点处医疗信息沟通不畅导致了高达50%的用药错误”,这类用药错误的一个主要原因是消费者缺乏药品信息知识。本研究旨在设计并测试一种消费者 - 医疗保健专业人员合作模式对有效用药核对的有效性。该模式旨在增强消费者对其药品信息的了解,以便他们能更有效地参与用药核对,从而最大限度减少在交接点发生的用药错误。该模式的组成部分参考了从患者意见调查中收集的定性数据、涉及在医院工作的护士、医生和药剂师的焦点小组会议结果以及用药安全工具的文献检索结果。项目开发以围绕计划 - 执行 - 研究 - 行动循环的健康改善方法为依据。在对照前后研究的框架内进行了有效性评估。

结果

显示药剂师干预的报告率提高了1.4倍。该研究未能证明所设计的干预措施在最大限度减少险些发生的错误方面有效。然而,对于正确接受干预的患者,错误有统计学上不显著的减少。轶事证据表明,对于渴望更多地掌握自身药品信息的患者群体有实用价值。此外,我们主张在患者入院前就开展药品患者教育并建立消费者 - 医疗保健专业人员模式。

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