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患者出院时社区药剂师面临的药品调配问题:一项关于阿尔萨斯地区537张处方的研究

Drug-dispensing problems community pharmacists face when patients are discharged from hospitals: a study about 537 prescriptions in Alsace.

作者信息

Michel Bruno, Hemery Marie, Rybarczyk-Vigouret Marie-Christine, Wehrlé Pascal, Beck Morgane

机构信息

OMEDIT Alsace, Agence Régionale de Santé d'Alsace, 67084 Strasbourg Cedex, France.

Service de Pharmacie, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Laboratoire HuManiS-EA 7308, Faculté de Pharmacie, Université de Strasbourg, 67098 Strasbourg Cedex, France.

出版信息

Int J Qual Health Care. 2016 Dec 1;28(6):779-784. doi: 10.1093/intqhc/mzw111.

DOI:10.1093/intqhc/mzw111
PMID:27655792
Abstract

OBJECTIVES

To identify both type and frequency of the challenges community pharmacists face when dispensing drugs from hospital discharge prescriptions, to describe the measures undertaken to resolve the issues at stake and to list their consequences.

DESIGN

We carried out an observational study in the community pharmacies of the French region of Alsace and asked the community pharmacy staff to review 537 hospital discharge prescriptions in 2013 using anonymous data collection forms.

SETTING AND PARTICIPANTS

Nineteen community pharmacies.

MAIN OUTCOME MEASURES

Number of patients informed about their medication (at hospital and/or community pharmacy), type and frequency of issues encountered during drug dispensing, type and frequency of measures undertaken to resolve the issues, type and frequency of the consequences regarding drug dispensing.

RESULTS

Community pharmacists faced 165 challenges from 145 hospital discharge prescriptions (i.e. 27.5% out of 528 analysed prescriptions), mostly correlated to the quality of the prescriptions (n = 100, 60.6%) or to logistical matters (n = 54, 32.7%). A mere 36.8% of the patients received information pertaining to their medication while being hospitalized. Of note, 40.5% of the prescriptions were delivered to pharmacies within 2 days following the patients' discharge. In order to resolve the different issues preventing drugs from being dispensed (n = 33/145 prescriptions), pharmacists sought information, mainly from patients, colleagues and hospital prescribers. The pharmacists were able to dispense all the drugs prescribed in 138 out of 145 cases (95.2%).

CONCLUSIONS

This study highlighted the challenges encountered by community pharmacists and their significant contribution to the continuity of care upon patients being discharged from hospitals.

摘要

目的

确定社区药剂师在调配出院处方药物时面临的挑战类型和频率,描述为解决相关问题所采取的措施,并列出其后果。

设计

我们在法国阿尔萨斯地区的社区药房开展了一项观察性研究,要求社区药房工作人员使用匿名数据收集表,对2013年的537份出院处方进行审查。

地点和参与者

19家社区药房。

主要观察指标

了解其用药情况的患者数量(在医院和/或社区药房)、配药过程中遇到的问题类型和频率、解决问题所采取措施的类型和频率、配药后果的类型和频率。

结果

社区药剂师在145份出院处方中面临165项挑战(即528份分析处方中的27.5%),主要与处方质量(n = 100,60.6%)或后勤问题(n = 54,32.7%)相关。只有36.8%的患者在住院期间收到了与其用药相关的信息。值得注意的是,40.5%的处方在患者出院后2天内送达药房。为了解决妨碍配药的各种问题(n = 33/145份处方),药剂师主要从患者、同事和医院开方者那里寻求信息。药剂师在145例中有138例(95.2%)能够配出所有处方药物。

结论

本研究突出了社区药剂师遇到的挑战以及他们对患者出院后护理连续性的重大贡献。

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