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[出院用药——患者对出院时所服药物了解多少?]

[Discharge medication - what do patients know about their medication on discharge?].

作者信息

Freyer J, Greißing C, Buchal P, Kabitz H-J, Kasprick L, Schuchmann M, Sultzer R, Schiek S, Bertsche T

出版信息

Dtsch Med Wochenschr. 2016 Jul;141(15):e150-6. doi: 10.1055/s-0042-108618. Epub 2016 Jul 27.

Abstract

BACKGROUND

Patients' lack of knowledge about their discharge medication can endanger patients' safety after their hospital stay. This is especially the case with regard to medications that were newly prescribed during the hospital stay and are intended to be used after discharge or medications with an increased risk for adverse drug reactions (high-risk drugs). The aim of this study was to analyse the patients' level of knowledge about their discharge medication and to identify influence factors.

METHODS

In a bicentric survey patients were interviewed prior to their discharge from an acute and a geriatric rehabilitation hospital. They were asked about their discharge medication in a structured interview. Influence factors were statistically analysed by Tobit regression.

RESULTS

In total, 179 patients were interviewed. On average, patients named 48% of their discharge medication correctly (95% CI: 46-50%). Influence factors for knowledge deficits were the lack of a medication plan, an older age, the hospitalization in a rehabilitation hospital and a long hospitalization. 81% of the patients had at least one drug in their discharge medication, which was newly prescribed during the hospital stay. 11% of those drugs were named correctly, the potency was named correctly in 6%, the indication in 8%. For almost two-thirds of the patients at least one high-risk drug was recommended in the discharge letter, among them most frequently oral anticoagulants and opioid analgesics. 38% of these high-risk drugs were named correctly.

CONCLUSION

Our results demonstrate an urgent need to train patients about their discharge medication, especially if medications are included that were newly prescribed during the hospital stay and recommended for further use after discharge or medications with an increased risk of adverse drug reactions. Particularly older patients and patients of a rehabilitation hospital after long hospitalization should be intensively counselled and obtain a medication plan upon discharge.

摘要

背景

患者对出院用药缺乏了解可能会危及他们出院后的安全。对于住院期间新开具的、出院后仍需使用的药物或药物不良反应风险增加的药物(高风险药物)而言,情况尤其如此。本研究的目的是分析患者对出院用药的了解程度,并确定影响因素。

方法

在一项双中心调查中,对急性康复医院和老年康复医院的患者在出院前进行访谈。通过结构化访谈询问他们的出院用药情况。采用 Tobit 回归对影响因素进行统计分析。

结果

总共对 179 名患者进行了访谈。患者平均正确说出了 48%的出院用药(95%置信区间:46 - 50%)。知识缺乏的影响因素包括缺乏用药计划、年龄较大、在康复医院住院以及住院时间较长。81%的患者出院用药中至少有一种是住院期间新开具的。这些药物中,11%被正确说出,6%正确说出了药效,8%正确说出了适应证。在出院小结中,近三分之二的患者至少有一种高风险药物被推荐,其中最常见的是口服抗凝药和阿片类镇痛药。这些高风险药物中,38%被正确说出。

结论

我们的结果表明迫切需要对患者进行出院用药培训,特别是当出院用药包括住院期间新开具的、出院后仍需继续使用的药物或药物不良反应风险增加的药物时。尤其对于老年患者以及长期住院后的康复医院患者,应在出院时给予深入的咨询并提供用药计划。

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