School of Pharmacy, University of Otago, PO Box 56, Dunedin, 9054, New Zealand,
Int J Clin Pharm. 2014 Jun;36(3):498-502. doi: 10.1007/s11096-014-9935-8. Epub 2014 Apr 4.
There can be a lack of transfer of information between hospitals and community pharmacies following patient discharge, which puts patients at a high risk of suffering drug related problems (DRPs). Community pharmacy plays a vital role in identifying and solving these discharge DRPs and taking action before these DRPs can lead to patient harm.
To identify the types and quantities of DRPs that community pharmacies detect within a single district health board (DHB) in New Zealand.
One DHB in New Zealand that contains 50 community pharmacies, which receive discharge prescriptions from two local hospitals.
All community pharmacies in the DHB area (n = 50) were invited to participate in the 2 week study which involved documenting the number of hospital discharge prescriptions received, and then the number and type of DRPs identified and what interventions were required.
The number and type of DRPs identified as a proportion of all discharge prescriptions received during the 2 week study period.
Initially a total of 38 pharmacies agreed to participate in this study, however only 32 pharmacies provided data for the entire 2 week period. Over a 2 week period a total of 1,374 hospital discharge prescriptions were presented to these pharmacies. From these prescriptions 344 (25 %) required further action to be taken by the pharmacist. These 344 prescriptions consisted of a total of 396 individual DRPs. Actions classified as "Supply and/or Funding" accounted for 43 % (171), which represented the largest class of all actions required from hospital discharge prescriptions. This class consisted of "Special Authority" problems, medications not being available, non-subsidised items on the prescription and other supply/funding problems. "Errors" accounted for 38 % (151) which included errors of omission (20 %) and errors of commission (18 %).
This study found a significant number of DRPs identified by community pharmacists on hospital discharge prescriptions. These included missing and incorrect information which required clarification with prescribers. Interventions need to be put in place to reduce the number of errors and improve clarity of hospital discharge prescriptions. Better information sharing and understanding of medications available in primary care will reduce the potential for DRPs.
患者出院后，医院和社区药房之间可能存在信息传递不足的情况，这使患者面临药物相关问题（DRPs）的高风险。社区药房在识别和解决这些出院 DRPs 方面发挥着至关重要的作用，并在这些 DRPs 导致患者伤害之前采取行动。
确定新西兰一个单一地区卫生局（DHB）内社区药房发现的 DRPs 的类型和数量。
新西兰一个 DHB 包含 50 家社区药房，这些药房接收来自当地两家医院的出院处方。
邀请 DHB 区域内的所有社区药房（n=50）参加为期两周的研究，该研究涉及记录收到的出院处方数量，然后记录识别出的 DRPs 的数量和类型，以及需要采取的干预措施。
在两周研究期间，作为收到的所有出院处方比例的 DRPs 的数量和类型。
最初共有 38 家药房同意参与这项研究，但只有 32 家药房在整个两周期间提供了数据。在两周期间，共有 1374 张医院出院处方提交给这些药房。从这些处方中，有 344 张（25%）需要药剂师进一步采取行动。这些 344 张处方共涉及 396 个单独的 DRPs。被归类为“供应和/或资金”的行动占 43%（171），这是所有从医院出院处方中需要采取的行动中最大的一类。这一类包括“特殊授权”问题、药物不可用、处方上的非补贴项目和其他供应/资金问题。“错误”占 38%（151），其中包括遗漏错误（20%）和委员会错误（18%）。
这项研究发现，社区药剂师在医院出院处方上发现了大量的 DRPs。其中包括需要与处方医生澄清的缺失和错误信息。需要采取干预措施，以减少错误数量并提高医院出院处方的清晰度。更好地共享信息和了解初级保健中可用的药物将减少 DRPs 的发生。
