Albano Marie E, Bostwick Jolene R, Ward Kristen M, Fluent Thomas, Choe Hae Mi
1 University of Michigan College of Pharmacy, Ann Arbor, MI, USA.
2 Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA.
J Pharm Pract. 2018 Jun;31(3):304-311. doi: 10.1177/0897190017715391. Epub 2017 Jun 20.
To identify the number of medication discrepancies following establishment of a telephone-based, introductory pharmacy practice experience student-driven, medication reconciliation service for new patients in an ambulatory psychiatry clinic. Secondarily, to identify factors impacting medication discrepancies to better target medication profiles to reconcile and to evaluate whether the implementation of a call schedule effected clinic no-show rates.
This was a retrospective analysis of a telephone-based medication reconciliation service from June 2014 to January 2016.
At least 1 medication discrepancy was identified among 84.7% of medication profiles (N = 438), with a total of 1416 medication discrepancies reconciled (3.2 discrepancies per patient). Of the 1416 discrepancies, 38.6% were deletions, 38.9% were additions, and 22.5% were changes in dosage strength or frequency. Discrepancies pertaining to prescription medications totaled 57.8%. Student pharmacists were critical team members in the service. Patient's age, number of medications on the patient's list, and number of days since the last medication reconciliation were not clinically significant determinants for targeting medication profiles. There was a statistically significant reduction in the clinic no-show rates following implementation of a call schedule compared with no-show rates prior to call schedule implementation.
This student pharmacist-led telephone medication reconciliation service demonstrated the importance of medication reconciliation in ambulatory psychiatry by identifying numerous discrepancies within this population. Further, we demonstrated pharmacy students across various levels of education can assist in this process under the supervision of a pharmacist.
确定在一家门诊精神病诊所为新患者建立基于电话的、由学生驱动的药物重整服务后出现的药物差异数量。其次，确定影响药物差异的因素，以便更好地针对需要重整的药物档案，并评估实施电话安排是否会影响诊所的失约率。
这是一项对2014年6月至2016年1月基于电话的药物重整服务的回顾性分析。
在84.7%的药物档案（N = 438）中至少发现了1处药物差异，总共重整了1416处药物差异（每位患者3.2处差异）。在这1416处差异中，38.6%是删除，38.9%是添加，22.5%是剂量强度或频率的改变。与处方药相关的差异总计57.8%。学生药剂师是该服务中的关键团队成员。患者的年龄、患者清单上的药物数量以及自上次药物重整以来的天数，并非针对药物档案的具有临床意义的决定因素。与实施电话安排之前的失约率相比，实施电话安排后诊所的失约率有统计学意义的降低。
这项由学生药剂师主导的电话药物重整服务通过在该人群中发现大量差异，证明了药物重整在门诊精神病学中的重要性。此外，我们证明了不同教育水平的药学专业学生在药剂师的监督下可以协助这一过程。
