Van Hollebeke Mélanie, Talavera-Pons Sarah, Mulliez Aurélien, Sautou Valérie, Bommelaer Gilles, Abergel Armand, Boyer Anne
Pharmacy Department, University Hospital of Clermont-Ferrand, 63000, Clermont-Ferrand, France.
Clinical Research and Innovation Office, University Hospital of Clermont-Ferrand, 63000, Clermont-Ferrand, France.
Int J Clin Pharm. 2016 Oct;38(5):1149-56. doi: 10.1007/s11096-016-0344-z. Epub 2016 Jul 18.
Background Care transitions from hospital to community have been identified as risk points for the continuity of patient care. Without upstream information, the community pharmacist (CP) cannot ensure error-free drug dispensing. A hospital-to-community records transmission process would enable CPs to guarantee that all prescription drugs are ready to pick up at hospital discharge, and to improve their responses to patient health inquiries. Objective To evaluate the impact of a hospital-to-CP medication records scheme on post-discharge continuity of patient treatment. Setting A University Hospital Digestive Surgery Department. Method Prospective, single-center, randomized pilot study. Eligible adult Digestive Surgery department patients discharged home over a period of 4 months were included. The medication reconciliation procedure was the same in both arms of the study. For patients included in the intervention group, CPs were sent the discharge prescription, patient medication list, and clinical and biological data required for drug dispensing. At 7 ± 2 days post-discharge, the CPs were surveyed by questionnaire. Seamlessness of drug continuity, use of the discharge medication form, and CP satisfaction with the scheme were assessed. Main outcome measures Prevalence of medication shortages, i.e. CPs unable to supply the appropriate drugs at discharge, and CP satisfaction levels, analyzed using Chi squared test. Results 124 patients were included. Of 124 CPs surveyed, 104 returned a completed questionnaire. Analysis found medication shortage in 10 control-group patients and one intervention-group patient (p < 0.005), non-availability of the full prescription in 24 % of control-group patients and 6 % of intervention-group patients (p < 0.013). In terms of CP satisfaction, 96 % of the intervention-group CPs stated that they were satisfied with the new hospital-to-community liaison initiative, while just 24 % of control-group CPs were satisfied with the current level of hospital-to-community liaison. Mean hospital pharmacist time input required for this initiative was an estimated 21 min for the control group versus 35 min for the intervention group. Conclusion The results provide a strong rationale for embedding the process longer-term and extending it out to other healthcare services. A pre-project study is needed to define which service departments and patients groups should be given priority for this process initiative.
背景 从医院到社区的护理过渡已被确定为患者护理连续性的风险点。没有上游信息，社区药剂师（CP）就无法确保无差错配药。医院到社区的记录传输流程将使CP能够保证所有处方药在出院时即可取药，并改善他们对患者健康咨询的回应。目的 评估医院到CP用药记录方案对出院后患者治疗连续性的影响。地点 一所大学医院的消化外科。方法 前瞻性、单中心、随机试点研究。纳入了在4个月期间出院回家的符合条件 的成年消化外科患者。研究的两组用药核对程序相同。对于干预组的患者，向CP发送出院处方、患者用药清单以及配药所需的临床和生物学数据。在出院后7±2天，通过问卷调查CP。评估药物连续性的无缝衔接、出院用药表格的使用以及CP对该方案的满意度。主要结局指标 药物短缺的发生率，即CP在出院时无法提供合适的药物，以及CP的满意度水平，使用卡方检验进行分析。结果 纳入124例患者。在接受调查的124名CP中，104名返回了完整的问卷。分析发现，对照组有10名患者存在药物短缺，干预组有1名患者存在药物短缺（p<0.005）；24%的对照组患者和6%的干预组患者无法获取完整处方（p<0.013）。在CP满意度方面，96%的干预组CP表示对新的医院到社区联络举措感到满意，而对照组中只有24%的CP对当前的医院到社区联络水平感到满意。该举措估计平均需要医院药剂师投入的时间，对照组为21分钟，干预组为35分钟。结论 研究结果为将该流程长期嵌入并扩展到其他医疗服务提供了有力依据。需要进行项目前研究，以确定该流程举措应优先考虑哪些服务部门和患者群体。
