From the Department of Anesthesiology, Rhode Island Hospital, and Alpert School of Medicine, Brown University.
Department of Anesthesiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
J Patient Saf. 2021 Aug 1;17(5):375-380. doi: 10.1097/PTS.0000000000000283.
Medication errors are common during transitions of care. The main objective of the current investigation was to examine the effectiveness of pharmacist-based transition of care interventions on the reduction of medication errors after hospital discharge.
A systematic search was conducted to detect published reports of randomized trials using the National Library of Medicine's PubMed database, the Cochrane Database of Systematic Reviews, and Google Scholar inclusive to July 1, 2015. Search terms included pharmacist, medication, errors, readmission, transition, and discharge. A priori main outcomes included medication errors and health-care resources utilization (hospital readmission and/or emergency room visits). Quantitative analysis was performed using a random effect method.
Thirteen randomized trials examining 3503 patients were included in the final analysis. The aggregate effect of the 10 studies evaluating the effect of pharmacists intervention on the incidence of medication errors during transitions of care favored pharmacist over control with an odds ratio (95% confidence interval [CI]) of 0.44 (0.31-0.63). The overall effect of 4 studies evaluating the effect of a pharmacist intervention on the incidence of emergency room visits compared with control favored the pharmacist intervention, odds ratio (95% CI) of 0.42 (0.22-0.78), number needed to treat (95% CI) of 6.2 (3.4-31.4).
Pharmacist transition of care intervention is an effective strategy to reduce medication errors after hospital discharge. In addition, a pharmacist intervention also reduces subsequent emergency room visits. Hospitals should consider implementing this intervention to improve patient safety and quality during transitions of care.
在医疗护理交接过程中,用药错误较为常见。本研究的主要目的是检验以药师为基础的医疗护理交接干预措施在降低出院后用药错误方面的效果。
系统检索了截至 2015 年 7 月 1 日,美国国立医学图书馆的 PubMed 数据库、考科兰协作网的系统评价数据库和谷歌学术中发表的随机试验报告。检索词包括药师、用药、错误、再入院、交接和出院。主要结局指标包括用药错误和卫生保健资源利用(住院再入院和/或急诊就诊)。采用随机效应法进行定量分析。
最终分析纳入了 13 项共 3503 例患者的随机试验。在评估药师交接干预对交接期间用药错误发生率影响的 10 项研究中,药师干预组的用药错误发生率较对照组更优,优势比(95%置信区间)为 0.44(0.31-0.63)。在评估药师交接干预对急诊就诊发生率影响的 4 项研究中,药师干预组的急诊就诊发生率较对照组更优,优势比(95%置信区间)为 0.42(0.22-0.78),需要治疗的人数(95%置信区间)为 6.2(3.4-31.4)。
药师交接干预是降低出院后用药错误的有效策略。此外,药师干预还可降低随后的急诊就诊率。医院应考虑实施这种干预措施,以改善交接期间的患者安全和质量。