Jarrett Traci, Cochran Jill, Baus Adam, Delmar Kayla
WV Office of Health Services Research, WV Clinical Translational Science Institute, West Virginia University School of Public Health, Morgantown, West Virginia.
West Virginia School of Osteopathic Medicine, WV Clinical Translational Science Institute, Lewisburg, West Virginia.
J Am Assoc Nurse Pract. 2019 Dec;31(12):760-765. doi: 10.1097/JXX.0000000000000197.
Medication reconciliation is a critical step in the health care process to prevent hospital readmission, adverse drug events, and fall prevention. The purpose of the study was to pilot test a medication reconciliation process, MedManage, informed by the Medications at Transitions and Clinical Handoffs (MATCH) toolkit with nursing staff in a rural primary care clinic.
The research team conducted 38 chart audits of high-risk patients, and preintervention and postintervention were conducted to assess changes in medications reported by patients. The intervention included a chart audit tool and medication reconciliation tool created by the interdisciplinary team, MedManage, were pilot tested in the clinic.
The Use of MedManage resulted in improvements in patient reporting of over-the-counter (82% of patients reported previously unrecorded OTCs), PRN medications (3% unreported), and herbal supplements/vitamins (28% reported previously unrecorded vitamins).
MedManage may be an effective tool to assist clinical nursing staff to attain a more complete and accurate medication list from patients and should be assessed more broadly across rural primary care clinics.
用药核对是医疗保健过程中的关键步骤，可预防医院再入院、药物不良事件和跌倒。本研究的目的是在农村基层医疗诊所，对由跨学科团队依据《转科与临床交接时的用药情况》（MATCH）工具包设计的用药核对流程MedManage，在护理人员中进行试点测试。
研究团队对高危患者进行了38次病历审核，并在干预前后评估患者报告的用药变化。干预措施包括由跨学科团队创建的病历审核工具和用药核对工具MedManage，在诊所进行了试点测试。
使用MedManage后，患者报告的非处方药（82%的患者报告了之前未记录的非处方药）、按需服用药物（3%未报告）以及草药补充剂/维生素（28%报告了之前未记录的维生素）情况有所改善。
MedManage可能是一种有效的工具，可协助临床护理人员从患者那里获取更完整、准确的用药清单，应在农村基层医疗诊所更广泛地进行评估。
