Fernandes Olavo
Department of Pharmacy, University Health Network, and Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario.
Healthc Q. 2012;15 Spec No:42-9. doi: 10.12927/hcq.2012.22842.
Medication reconciliation arose as the solution to the well-documented patient safety problem of unintentionally introducing changes in patients' medication regimens due to incomplete or inaccurate medication information at transitions in care. Unfortunately, medication reconciliation has often been misperceived as a superficial administrative accounting task with a "pre-occupation with completing forms," resulting in the implementation of ineffective processes. In this article, the authors briefly review the evidence supporting medication reconciliation but focus more on key practical questions regarding the elements of an effective medication reconciliation process: what it should consist of, where and when it should occur, who should carry it out and how hospitals should implement it. The authors take the why of medication reconciliation to consist not just of the professional obligation to avoid causing harm, but also of a rational self-interest on the part of healthcare leaders. The authors argue that, rather than wasting time implementing a nominal reconciliation process, we should invest time and energy in a more robust and effective strategy, and they address specific practical questions that arise in such an effort.
药物重整作为一种解决方案应运而生，旨在解决一个有充分记录的患者安全问题，即由于医疗护理转接时用药信息不完整或不准确，无意中导致患者用药方案发生改变。不幸的是，药物重整常常被误解为一项表面的行政核算任务，只是“专注于填写表格”，导致实施的流程无效。在本文中，作者简要回顾了支持药物重整的证据，但更关注关于有效药物重整流程要素的关键实际问题：它应该包括哪些内容、应该在何处及何时进行、应该由谁来执行以及医院应该如何实施。作者认为，药物重整的意义不仅在于避免造成伤害的职业义务，还在于医疗保健领导者的合理自身利益。作者认为，与其浪费时间实施名义上的重整流程，我们应该投入时间和精力制定更强大、更有效的策略，并且他们还探讨了在这一过程中出现的具体实际问题。
