Mackridge Adam J, Rodgers Ruth, Lee Dan, Morecroft Charles W, Krska Janet
Betsi Cadwaladr University Health Board, Wrexham, UK.
Medway School of Pharmacy, Universities of Greenwich and Kent, Chatham Maritime, Kent, UK.
Int J Pharm Pract. 2018 Oct;26(5):433-441. doi: 10.1111/ijpp.12411. Epub 2017 Nov 20.
Most patients experience changes to prescribed medicines during a hospital stay. Ensuring they understand such changes is important for preventing adverse events post-discharge and optimising patient understanding. However, little work has explored the information that patients receive about medicines or their perceived needs for information and support after discharge.
To determine information that hospital inpatients who experience medicine changes receive about their medicines during admission and their needs and preferences for, and use of, post-discharge support.
Cross-sectional survey with adult medical inpatients experiencing medicine changes in six English hospitals, with telephone follow-up 2-3 weeks post-discharge.
A total of 444 inpatients completed surveys, and 99 of these were followed up post-discharge. Of the 444, 44 (10%) were unaware of changes to medicines and 65 (16%) did not recall discussing them with a health professional, but 305 (77%) reported understanding the changes. Type of information provided and patients' perceived need for post-discharge support differed between hospitals. Information about changes was most frequently provided by consultant medical staff (157; 39%) with pharmacists providing information least often (71; 17%). One third of patients surveyed considered community pharmacists as potential sources of information about medicines and associated support post-discharge. Post-discharge, just 5% had spoken to a pharmacist, although 35% reported medicine-related problems.
In north-west England, patient inclusion in treatment decisions could be improved, but provision of information prior to discharge is reasonable. There is scope to develop hospital and community pharmacists' role in medicine optimisation to maximise safety and effectiveness of care.
大多数患者在住院期间会经历所开药物的变更。确保他们理解这些变更对于预防出院后不良事件及优化患者认知至关重要。然而,很少有研究探讨患者在出院后所获得的关于药物的信息,或他们对信息及支持的感知需求。
确定经历药物变更的住院患者在住院期间所获得的关于其药物的信息,以及他们对出院后支持的需求、偏好和使用情况。
对英格兰六家医院中经历药物变更的成年内科住院患者进行横断面调查,并在出院后2至3周进行电话随访。
共有444名住院患者完成了调查,其中99名在出院后接受了随访。在这444名患者中,44名(10%)未意识到药物变更,65名(16%)不记得与医护人员讨论过这些变更,但305名(77%)表示理解这些变更。不同医院提供的信息类型以及患者对出院后支持的感知需求有所不同。关于变更的信息最常由内科顾问医生提供(157名;39%),而药剂师提供信息的频率最低(71名;17%)。三分之一的受访患者认为社区药剂师是出院后药物信息及相关支持的潜在来源。出院后,只有5%的患者与药剂师交谈过,尽管35%的患者报告有与药物相关的问题。
在英格兰西北部,可以改善患者参与治疗决策的情况,但出院前的信息提供情况还算合理。有必要拓展医院和社区药剂师在药物优化方面的作用,以最大限度地提高护理的安全性和有效性。