Utrecht University of Applied Sciences, Research Group Process Innovations in Pharmaceutical Care, Utrecht, The Netherlands; Utrecht Institute for Pharmaceutical Sciences (UIPS), Department of Pharmacoepidemiology & Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands; Zorggroep Almere, Outpatient Pharmacy "de Brug 24/7", Almere, The Netherlands.
Utrecht Institute for Pharmaceutical Sciences (UIPS), Department of Pharmacoepidemiology & Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands.
Res Social Adm Pharm. 2019 Mar;15(3):267-278. doi: 10.1016/j.sapharm.2018.05.001. Epub 2018 May 8.
Hospital discharge poses a significant threat to the continuity of medication therapy and frequently results in drug-related problems post-discharge. Therefore, establishing continuity of care by realizing optimal collaboration between hospital and community pharmacists is of utmost importance.
To evaluate the collaboration between hospital and community pharmacists on addressing drug-related problems after hospital discharge.
A prospective follow-up study was conducted between November 2013-December 2014 in a general hospital and all affiliated community pharmacies. Adult patients, admitted for ≥48 h to the neurology or pulmonology ward were eligible if they used ≥3 chronic prescription drugs and lived in the community pharmacies' service area. The HomeCoMe intervention program was comprised of medication verification and counseling at admission, medication screening by the hospital pharmacist during admission, outpatient pharmacy discharge consultation and support, and a community pharmacist home visit within one week post-discharge.
The mean age of the 152 included patients was 67.0 ± 12.6 years and 56.6% were female. A total of 745 DRPs (4.9 ± 2.2 DRPs per patient, range: 0-11) were identified with the need for additional "Education or information" (36.1%) and "Compliance" (16.4%) issues as most common DRP-types. This led to a total of 928 recommendations (6.1 ± 3.0 per patient, range: 1-19) to solve the DRP. The majority of DRPs were identified (83.6%, n = 623) and solved (91.6%, n = 682) by the community pharmacist during the home visit. Furthermore, 52.5% (n = 64) of the DRPs identified during hospitalization were solved during the post-discharge home visit.
Collaboration between hospital and community pharmacists from hospital admission to readmission to primary care is crucial to establish continuity of care. A post-discharge community pharmacist home visit is a valuable addition to in-hospital transitional care to identify and solve drug-related problems.
医院出院对药物治疗的连续性构成重大威胁，并经常导致出院后的药物相关问题。因此，通过实现医院和社区药剂师之间的最佳协作来建立连续性护理至关重要。
评估医院和社区药剂师在解决出院后药物相关问题方面的协作。
2013 年 11 月至 2014 年 12 月，在一家综合医院和所有附属社区药房进行了一项前瞻性随访研究。如果成人患者在神经病学或肺病科病房住院≥48 小时，使用≥3 种慢性处方药，并居住在社区药房的服务区域内，则有资格参加。HomeCoMe 干预计划包括入院时的药物验证和咨询、住院期间医院药剂师的药物筛选、门诊药房出院咨询和支持，以及出院后一周内的社区药剂师家访。
152 名纳入患者的平均年龄为 67.0±12.6 岁，56.6%为女性。共发现 745 个药物相关问题（每个患者 4.9±2.2 个药物相关问题，范围：0-11），需要额外的“教育或信息”（36.1%）和“合规性”（16.4%）问题作为最常见的药物相关问题类型。这导致共提出了 928 项建议（每个患者 6.1±3.0 项，范围：1-19）来解决药物相关问题。大多数药物相关问题（83.6%，n=623）是由社区药剂师在家庭访视期间发现并解决的（91.6%，n=682）。此外，在住院期间发现的 52.5%（n=64）药物相关问题在出院后的家庭访视中得到了解决。
从住院到重新入院到初级保健，医院和社区药剂师之间的协作对于建立连续性护理至关重要。出院后社区药剂师家访是住院过渡护理的有价值补充，可以发现和解决药物相关问题。
