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膳食补充剂的用药核对:不问不说。

Medical reconciliation of dietary supplements: don't ask, don't tell.

作者信息

Gardiner Paula, Sadikova Ekaterina, Filippelli Amanda C, White Laura F, Jack Brian W

机构信息

Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, USA.

Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, USA.

出版信息

Patient Educ Couns. 2015 Apr;98(4):512-7. doi: 10.1016/j.pec.2014.12.010. Epub 2015 Jan 14.

DOI:10.1016/j.pec.2014.12.010
PMID:25636694
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4404157/
Abstract

OBJECTIVE

To explore inpatient reconciliation of dietary supplement (DS) use and determine characteristics associated with DS documentation.

METHODS

We analyzed DS use among 558 inpatients recruited from the Re-Engineered Discharge clinical trial to identify: (1) if patients self-reported DS and (2) if DS use was documented at admission. We examined socio-demographics for association with documentation using chi squares and t-tests. Logistic regression was performed to assess adjusted associations with DS documentation.

RESULTS

Sixty percent reported DS use (n=333). Among users, 36% had admission DS documentation, 20% were asked about use at admission, 18% reported disclosing use to a provider, and 48% reported they would continue to use DS. Overall, 6% of participants were asked, disclosed, and had documentation of DS. Logistic regression revealed increased age associated with lower odds of DS documentation. Identifying as Hispanic or African American reduces DS documentation odds compared to those identifying as white.

CONCLUSIONS

There is lack of consistent DS medical reconciliation in the inpatient setting. While more than half of patients used DS prior to hospitalization, most were not asked about use on admission.

PRACTICE IMPLICATIONS

This study adds to literature on medical reconciliation which requires that providers inquire and document patient DS use.

摘要

目的

探讨住院患者膳食补充剂(DS)使用情况的核对,并确定与DS记录相关的特征。

方法

我们分析了从“重新设计出院”临床试验招募的558名住院患者的DS使用情况,以确定:(1)患者是否自我报告使用DS;(2)入院时是否记录了DS的使用情况。我们使用卡方检验和t检验检查社会人口统计学特征与记录情况之间的关联。进行逻辑回归分析以评估与DS记录的校正关联。

结果

60%的患者报告使用了DS(n = 333)。在使用者中,36%的患者入院时有DS记录,20%的患者在入院时被询问过使用情况,18%的患者报告向医护人员披露了使用情况,48%的患者报告他们会继续使用DS。总体而言,6%的参与者被询问、披露并记录了DS的使用情况。逻辑回归分析显示,年龄增加与DS记录的可能性降低相关。与白人相比,认定为西班牙裔或非裔美国人会降低DS记录的可能性。

结论

住院环境中缺乏对DS使用情况的一致核对。虽然超过一半的患者在住院前使用了DS,但大多数患者在入院时未被询问使用情况。

实践意义

本研究补充了有关医疗核对的文献,该核对要求医护人员询问并记录患者DS的使用情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8342/4404157/086746c26200/nihms-659651-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8342/4404157/086746c26200/nihms-659651-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8342/4404157/086746c26200/nihms-659651-f0001.jpg

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Adherence to medications after hospital discharge in the elderly.老年人出院后的药物依从性。
Int J Family Med. 2013;2013:901845. doi: 10.1155/2013/901845. Epub 2013 Mar 26.
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Absence of 'over-the-counter' medicinal products in on-line prescription records: a risk factor of overlooking interactions in the elderly.
老年人驾驶员普遍使用膳食补充剂:AAA LongROAD 研究分析。
BMC Complement Med Ther. 2024 Aug 30;24(1):319. doi: 10.1186/s12906-024-04623-x.
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Medication Discrepancies among Older Hospitalized Adults Discharged from Post-Acute Care Facilities to Home.老年住院患者从康复护理机构出院后居家用药差异。
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Healthcare Professionals' Perspectives on Improving Dietary Supplement Documentation in the Electronic Medical Record: Current Challenges and Opportunities to Enhance Quality of Care and Patient Safety.医疗保健专业人员对改善电子病历中膳食补充剂记录的看法:当前提高医疗质量和患者安全面临的挑战与机遇
Glob Adv Integr Med Health. 2023 Dec 19;12:27536130231215029. doi: 10.1177/27536130231215029. eCollection 2023 Jan-Dec.
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General practitioners' role in safeguarding patients with dementia in their use of dietary supplements. A qualitative study.全科医生在保障痴呆症患者使用膳食补充剂方面的作用。一项定性研究。
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Concomitant Administration of Capecitabine and Folate Supplements: Need to Encourage Medication Reconciliation.卡培他滨与叶酸补充剂的联合给药:需要促进用药核对。
Pharmaceuticals (Basel). 2022 Nov 10;15(11):1388. doi: 10.3390/ph15111388.
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Differences in the Perception of Dietary Supplements between Dietary Supplement/Medicine Users and Non-Users.膳食补充剂使用者与非使用者对膳食补充剂的认知差异。
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