[专科药剂师进行的协调干预对解决急诊科短期住院老年患者药物相关问题的疗效：一项随机临床试验]

[Efficacy of a reconciliation intervention by a specialized pharmacist to resolve medication-related problems of elderly patients admitted to an emergency department short-stay unit: a randomized clinical trial].

作者信息

Piqueras Romero Clara, Calderón Hernanz Beatriz, Segura Fragoso Antonio, Juárez González Ricardo, Berrocal Javato María Antonia, Calleja Hernández Miguel Ángel

机构信息

Servicio de Farmacia, Hospital Nuestra Señora del Prado, Talavera de la Reina, Toledo, España.

Grupo REDFASTER (SEFH), España, Servicio de Farmacia, Hospital Son Llatzer, Mallorca, España.

出版信息

Emergencias. 2015;27(6):364-370.

PMID:29094837

Abstract

OBJECTIVES

To determine the effect on medication-related problems (MRPs) of a process of medication reconciliation carried out by a specialized pharmacist for patients aged 65 years or older admitted to an emergency department short-stay unit (SSU).

MATERIAL AND METHODS

Randomized clinical trial of 17 months (February 2013-June 2014) in the SSU of a hospital emergency department. Patients were aged 65 years or older at high risk of MRPs. A total of 130 patients were randomized to a control group (n = 65) or the intervention group (n = 65). The reconciliation process (intervention) was carried out by a specialized pharmacist. The main outcome was the number of MRPs resolved in each group.

RESULTS

A total of 3081 medications for 130 patients were reviewed. The patients' mean (SD) age was 79 (7.6) years and 66 (50.8%) were men. Discrepancies affecting 1901 medications (61.7%) were detected. The distributions of age, sex, and number of medication discrepancies were similar in the control and intervention groups. A total of 213 MRPs were detected; 110 (51.6%) were in the control group and 103 (48.4%) in the intervention group (P = .380). Through the pharmacist's reconciliation, significantly more of the MRPs were resolved in the intervention group (83.5%) than in the control group (26.4%) (P < .001).

CONCLUSION

Medication reconciliation by a specialized pharmacist in the emergency department reduces MRPs for at-risk elderly patients in a SSU.

摘要

目的

确定由专业药剂师为入住急诊科短期留观病房（SSU）的65岁及以上患者进行用药核对流程对用药相关问题（MRP）的影响。

材料与方法

在一家医院急诊科的短期留观病房进行了为期17个月（2013年2月至2014年6月）的随机临床试验。患者为65岁及以上，存在MRP高风险。共130例患者被随机分为对照组（n = 65）或干预组（n = 65）。核对流程（干预）由专业药剂师进行。主要结局是每组中解决的MRP数量。

结果

对130例患者的总共3081种药物进行了审查。患者的平均（标准差）年龄为79（7.6）岁，男性66例（50.8%）。检测到影响1901种药物（61.7%）的差异。对照组和干预组在年龄、性别和用药差异数量的分布上相似。共检测到213个MRP；对照组有110个（51.6%），干预组有103个（48.4%）（P = 0.380）。通过药剂师的核对，干预组解决的MRP显著多于对照组（83.5%对26.4%）（P < 0.001）。