Kothari Medha, Maidment Ian, Lyon Ray, Haygarth Lynn
Aston University, Aston Triangle, Birmingham, B4 7ET, UK.
Sussex Partnership NHS Foundation Trust, Brighton, West Sussex, BN13 3EP, UK.
Int J Clin Pharm. 2016 Apr;38(2):289-95. doi: 10.1007/s11096-015-0236-7. Epub 2016 Jan 6.
Medicines reconciliation-identifying and maintaining an accurate list of a patient's current medications-should be undertaken at all transitions of care and available to all patients.
A self-completion web survey was conducted for chief pharmacists (or equivalent) to evaluate medicines reconciliation levels in secondary care mental health organisations.
The survey was sent to secondary care mental health organisations in England, Scotland, Northern Ireland and Wales.
The survey was launched via Bristol Online Surveys. Quantitative data was analysed using descriptive statistics and qualitative data was collected through respondents free-text answers to specific questions.
Investigate how medicines reconciliation is delivered, incorporate a clear description of the role of pharmacy staff and identify areas of concern.
Forty-two (52 % response rate) surveys were completed. Thirty-seven (88.1 %) organisations have a formal policy for medicines reconciliation with defined steps. Results show that the pharmacy team (pharmacists and pharmacy technicians) are the main professionals involved in medicines reconciliation with a high rate of doctors also involved. Training procedures frequently include an induction by pharmacy for doctors whilst the pharmacy team are generally trained by another member of pharmacy. Mental health organisations estimate that nearly 80 % of medicines reconciliation is carried out within 24 h of admission. A full medicines reconciliation is not carried out on patient transfer between mental health wards; instead quicker and less exhaustive variations are implemented. 71.4 % of organisations estimate that pharmacy staff conduct daily medicine reconciliations for acute admission wards (Monday to Friday). However, only 38 % of organisations self-report to pharmacy reconciling patients' medication for other teams that admit from primary care.
Most mental health organisations appear to be complying with NICE guidance on medicines reconciliation for their acute admission wards. However, medicines reconciliation is conducted less frequently on other units that admit from primary care and rarely completed on transfer when it significantly differs to that on admission. Formal training and competency assessments on medicines reconciliation should be considered as current training varies and adherence to best practice is questionable.
药物重整——识别并维护患者当前用药的准确清单——应在所有医疗转接过程中进行，并提供给所有患者。
针对主任药师（或同等职位人员）开展了一项自我完成式网络调查，以评估二级医疗心理健康机构中的药物重整水平。
该调查发送给了英格兰、苏格兰、北爱尔兰和威尔士的二级医疗心理健康机构。
通过布里斯托尔在线调查平台发起该调查。定量数据采用描述性统计进行分析，定性数据通过受访者对特定问题的自由文本回答收集。
调查药物重整的实施方式，明确描述药房工作人员的角色，并识别关注领域。
共完成42份调查（回复率52%）。37个（88.1%）组织有关于药物重整的正式政策及明确步骤。结果显示，药房团队（药师和药房技术员）是参与药物重整的主要专业人员，医生参与率也较高。培训程序通常包括药房对医生的入职培训，而药房团队一般由药房的其他成员进行培训。心理健康机构估计，近80%的药物重整在入院后24小时内完成。在心理健康病房之间患者转院时未进行全面的药物重整；而是采用了更快且更不详尽的变通方式。71.4%的组织估计药房工作人员会为急性入院病房（周一至周五）进行每日药物重整。然而，只有38%的组织自我报告药房为从初级医疗接收患者的其他团队核对患者用药。
大多数心理健康机构似乎遵守了英国国家卫生与临床优化研究所（NICE）关于急性入院病房药物重整的指南。然而，在从初级医疗接收患者的其他科室，药物重整的开展频率较低，并且在转院时与入院时差异较大时很少完成。鉴于当前培训各不相同且对最佳实践的遵循情况存疑，应考虑对药物重整进行正式培训和能力评估。
