Al-Ghamdi Sami Ali, Mahmoud Mansour Adam, Alammari Maha Abdalaziz, Al Bekairy Abdulkareem Mohamed, Alwhaibi Muneera, Mayet Ahmad Yacoub, Aljadhey Hisham Saad
King Abdulaziz Medical City, National Guard Health Affairs, Saudi Arabia.
Ann Saudi Med. 2012 Sep-Oct;32(5):492-7. doi: 10.5144/0256-4947.2012.492.
Adverse drug events (ADEs) may occur after discharge from acute care hospitalization because of limited instruction on medications at discharge. The right instructions given to patients may reduce the risk of ADEs. The objective of our study was to assess a program involving comprehensive medication counseling provided by pharmacists at the time of discharge from a tertiary hospital in Riyadh, Saudi Arabia.
A prospective, nonrandomized observational study over a period of 3 months in a 1000-bed tertiary hospital.
Patients discharged from the internal medicine wards with more than three medications received comprehensive pharmacist counseling. The intervention pharmacist counseled patients about their discharge medications and provided written materials as needed. Topics discussed with the patients included the importance of following prescribed medication regimens and the indications, directions, and any potential side effects of discharge medications. The control group included similar patients who received routine discharge counseling by nurses. Two weeks after discharge, the same pharmacist called the patients and assessed the frequency of ADEs. Two independent clinicians reviewed each ADEs and judged its severity and preventability.
Out of 200 patients included in the study (100 patients from the intervention group and 100 patients from the control group), 175 patients (87.5%) were successfully contacted two weeks after discharge (88 patients from the intervention group and 87 patients from the control group). ADEs occurred in 2 patients (2.3%) in the intervention group and in 21 patients (24%; 23 incidents in 21 patients) in the control group (P < .001). In the control group, 14 ADEs (61%) were judged as preventable, and 9 (39%) were judged as serious.
A comprehensive medication counseling program at hospital discharge reduced the incidence of ADEs two weeks after discharge from a tertiary hospital in Riyadh, Saudi Arabia. Further studies assessing the long-term outcomes of such a program are needed.
急性护理住院出院后可能会发生药物不良事件（ADEs），原因是出院时药物使用指导有限。给予患者正确的指导可能会降低药物不良事件的风险。我们研究的目的是评估一项由沙特阿拉伯利雅得一家三级医院的药剂师在出院时提供全面药物咨询的项目。
在一家拥有1000张床位的三级医院进行为期3个月的前瞻性、非随机观察性研究。
从内科病房出院且服用三种以上药物的患者接受了药剂师的全面咨询。干预组药剂师就出院用药向患者提供咨询，并根据需要提供书面材料。与患者讨论的主题包括遵循规定用药方案的重要性以及出院药物的适应症、用法和任何潜在副作用。对照组包括接受护士常规出院咨询的类似患者。出院两周后，同一名药剂师致电患者并评估药物不良事件的发生率。两名独立的临床医生对每起药物不良事件进行审查，并判断其严重程度和可预防性。
在纳入研究的200名患者中（干预组100名患者，对照组100名患者），175名患者（87.5%）在出院两周后成功取得联系（干预组88名患者，对照组87名患者）。干预组有2名患者（2.3%）发生了药物不良事件，对照组有21名患者（24%；21名患者发生23起事件）发生了药物不良事件（P <.001）。在对照组中，14起药物不良事件（61%）被判定为可预防，9起（39%）被判定为严重。
沙特阿拉伯利雅得一家三级医院实施的出院时全面药物咨询项目降低了出院两周后药物不良事件的发生率。需要进一步研究评估该项目的长期效果。
