Gortney Justine S, Moser Lynette R, Patel Priyasha, Raub Joshua N
1 Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA.
2 Olympia LLC, Livonia, MI, USA.
J Pharm Pract. 2019 Aug;32(4):404-411. doi: 10.1177/0897190018759224. Epub 2018 Feb 20.
Many studies have shown the positive impact that student pharmacists have on patients' health; however, no studies have been published evaluating student pharmacists' impact on direct patient outcomes (ie, readmission, emergency department [ED] visits, length of stay) related to the medication history process.
To evaluate the impact of student pharmacist-obtained medication histories on identification of medication discrepancies and clinical outcomes.
Student pharmacists obtained medication histories and then compared the history to that obtained by other health-care providers. Students documented discrepancies and interventions were completed. Control patients were identified and discharge medication list and 30-day readmissions were compared.
Seventeen students conducted 215 patient interviews, and 1848 modifications were made to documented home medications in the electronic medical record. Compared to controls (n = 148 student pharmacist, 149 controls), a nonsignificant improvement was found in discharge medication list completeness scores in patients seen by student pharmacists (3.94 vs 3.63; = .06); but no difference was found in accuracy scores (0.92 vs 0.93; = .41). Fewer ED visits at 30 days were found in the student pharmacist group (8 vs 18; = .045), with no difference in readmissions.
Student pharmacist-obtained medication histories improved the information available for identifying drug-related problems for inpatients, completeness of the discharge medication list, and ED visits within 30 days.
许多研究表明学生药剂师对患者健康有积极影响；然而，尚未发表任何研究评估学生药剂师对与用药史过程相关的直接患者结局（即再入院、急诊就诊、住院时间）的影响。
评估学生药剂师获取的用药史对识别用药差异和临床结局的影响。
学生药剂师获取用药史，然后将其与其他医疗服务提供者获取的用药史进行比较。学生记录差异并完成干预措施。确定对照患者，并比较出院用药清单和30天再入院情况。
17名学生进行了215次患者访谈，电子病历中记录的家庭用药信息有1848处修改。与对照组（148名学生药剂师，149名对照）相比，学生药剂师诊治的患者出院用药清单完整性评分有非显著性改善（3.94对3.63；P = 0.06）；但准确性评分无差异（0.92对0.93；P = 0.41）。学生药剂师组30天时的急诊就诊次数较少（8次对18次；P = 0.045），再入院情况无差异。
学生药剂师获取的用药史改善了用于识别住院患者药物相关问题的可用信息、出院用药清单的完整性以及30天内的急诊就诊情况。
