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初级保健医生在出院时的沟通可减少用药差异。

Primary care physician communication at hospital discharge reduces medication discrepancies.

作者信息

Lindquist Lee A, Yamahiro Atsuko, Garrett Arianne, Zei Charles, Feinglass Joseph M

机构信息

Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

出版信息

J Hosp Med. 2013 Dec;8(12):672-7. doi: 10.1002/jhm.2098. Epub 2013 Nov 1.

Abstract

BACKGROUND

Medication discrepancies are common as patients transition from hospital to home. Errors with post-discharge medication regimens may play a role in hospital readmissions.

OBJECTIVES

To determine whether primary care physician (PCP) contact with patients at hospital discharge impacts the frequency of medication discrepancies at 24 hours post-discharge.

DESIGN

With the PCP-Enhanced Discharge Communication Intervention, PCPs were asked to speak with treating hospitalists and contact patients within 24 hours of hospital discharge (either in person or by phone) to discuss any hospital medication changes. Research staff enrolled subjects during their hospitalization and telephoned subjects 48 hours post-discharge to determine medication discrepancies and PCP contact.

PARTICIPANTS

One hundred fourteen community-dwelling adults, admitted to acute medicine services >24 hours on ≥ 5 medications.

RESULTS

Of the 114 subjects enrolled in the hospital, 75 subjects completed 48 hours postdischarge phone interviews. Of the 75 study patients, 39 patients (50.6%) experienced a total of 84 medication discrepancies (mean, 2.1 discrepancies/patient). Subjects who were contacted by their PCP at discharge were 70% less likely to have a discrepancy when compared with those not contacted (P = 0.04). Males were 4.34 times more likely to have a discrepancy (P = 0.02).

CONCLUSION

PCP communication with patients within 24 hours of discharge was associated with decreased medication discrepancies. Our results further demonstrate the importance of PCP involvement in the hospital discharge process.

摘要

背景

患者从医院过渡到家庭时,用药差异很常见。出院后用药方案的错误可能在医院再入院中起作用。

目的

确定初级保健医生(PCP)在患者出院时与其联系是否会影响出院后24小时用药差异的发生率。

设计

通过PCP强化出院沟通干预,要求PCP与主治住院医生交谈,并在出院后24小时内(亲自或通过电话)联系患者,讨论医院用药的任何变化。研究人员在患者住院期间招募受试者,并在出院后48小时给受试者打电话,以确定用药差异和PCP联系情况。

参与者

114名社区居住的成年人,因急性内科疾病住院超过24小时,且服用≥5种药物。

结果

在医院招募的114名受试者中,75名受试者完成了出院后48小时的电话访谈。在这75名研究患者中,39名患者(50.6%)共出现84次用药差异(平均每名患者2.1次差异)。出院时与PCP联系的受试者出现差异的可能性比未联系的受试者低70%(P = 0.04)。男性出现差异的可能性是女性的4.34倍(P = 0.02)。

结论

出院后24小时内PCP与患者沟通可减少用药差异。我们的结果进一步证明了PCP参与医院出院过程的重要性。

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