Chan Bosco, Reeve Emily, Matthews Slade, Carroll Peter R, Long Janet C, Held Fabian, Latt Mark, Naganathan Vasi, Caplan Gideon A, Hilmer Sarah N
Kolling Institute of Medical Research, Royal North Shore Hospital and University of Sydney, Sydney, Australia.
Sydney Medical School, University of Sydney, Sydney, Australia.
Br J Clin Pharmacol. 2017 Jun;83(6):1185-1196. doi: 10.1111/bcp.13222. Epub 2017 Feb 1.
Effective transfer of information is vital for rational drug therapy. This is particularly important for older patients, who have a high prevalence of polypharmacy and are managed by multidisciplinary teams. We aimed to assess medicine information exchange (MIE) networks in geriatric medicine wards and whether they are associated with prescribing patterns.
We conducted network analysis in acute geriatric medicine wards from four hospitals to characterize MIE networks among multidisciplinary team members. Corresponding patient data were collected to analyze high-risk prescribing in conjunction with network characteristics.
We found that junior doctors, senior nurses and pharmacists were central to MIE across all four hospitals. Doctors were more likely than other professions to receive medicines information in three hospitals. Reciprocity and the tendency to communicate within one's own profession also influenced network formation. No difference was observed in prescribing practice between hospitals.
Understanding MIE networks can identify gaps in multidisciplinary communication that can be addressed. Networks may identify targets for dissemination of interventions to improve prescribing.
有效的信息传递对于合理用药治疗至关重要。这对于老年患者尤为重要，因为他们多重用药的发生率很高，且由多学科团队进行管理。我们旨在评估老年医学病房中的药物信息交流（MIE）网络，以及它们是否与处方模式相关。
我们对四家医院的急性老年医学病房进行了网络分析，以描述多学科团队成员之间的MIE网络特征。收集了相应的患者数据，结合网络特征分析高风险处方。
我们发现，在所有四家医院中，初级医生、高级护士和药剂师是MIE的核心。在三家医院中，医生比其他职业的人更有可能收到药物信息。互惠性以及在同一职业内交流的倾向也影响了网络的形成。各医院之间在处方实践方面未观察到差异。
了解MIE网络可以识别多学科沟通中可以解决的差距。网络可以确定传播干预措施以改善处方的目标。
