Department of Pharmacy, Royal Prince Alfred Hospital, Level 5, Building 65, Missenden Road, Camperdown, 2050, Australia.
Department of Emergency Medicine, Royal Prince Alfred Hospital, Level 5, Building 65, Missenden Road, Camperdown, 2050, Australia.
Am J Emerg Med. 2020 Jan;38(1):50-54. doi: 10.1016/j.ajem.2019.04.016. Epub 2019 Apr 13.
The primary objective of this study was to determine the proportion of patients with medication discrepancies when using a self-administered medication history form in the emergency department (ED). The secondary objectives were to identify predictors of medication discrepancies and determine the proportion of patients with a high-risk medication discrepancy.
This was a cross-sectional study conducted in an urban ED in Australia. Patients completed a self-administered medication history form while waiting to be seen by a physician. Subsequently, a best possible medication history was taken by a pharmacist to determine accuracy of the self-reported medication lists for patients with planned admissions. Discrepancies between the two medication lists were reported descriptively. A Poisson regression analysis was conducted to identify predictors of the rate of discrepancies. Associations were reported as incident rate ratios (IRR).
A total of 138 patients were included in the study. The total number of discrepancies was as follows: 0 (25%, n = 34), 1 (34%, n = 47), 2 (11%, n = 15), and ≥3 (30%, n = 42). The number of medications (IRR 1.11, 95% CI 1.09 to 1.14, p < 0.001), female (IRR 1.51, 95% CI 1.18 to 1.92, p = 0.001), and missing community pharmacy information (IRR 2.10, 95% CI 1.64 to 2.68, p < 0.001) were significantly associated with rate of discrepancies. Overall, 20% (n = 28) of patients had one or more high-risk medication discrepancies.
Patient self-administered medication history forms have a high rate of discrepancies and should be verified by a best possible medication history.
本研究的主要目的是确定在急诊科使用患者自行填写的用药史表时出现用药差异的患者比例。次要目的是确定用药差异的预测因素，并确定具有高风险用药差异的患者比例。
这是一项在澳大利亚城市急诊科进行的横断面研究。患者在等待医生就诊时填写一份自行管理的用药史表。随后，药剂师会尽可能地获取最佳用药史，以确定计划入院患者自我报告用药清单的准确性。报告了两种用药清单之间的差异。采用泊松回归分析确定差异率的预测因素。关联以发病率比（IRR）表示。
共纳入 138 例患者。差异总数如下：0（25%，n=34）、1（34%，n=47）、2（11%，n=15）和≥3（30%，n=42）。药物数量（IRR 1.11，95%CI 1.09 至 1.14，p<0.001）、女性（IRR 1.51，95%CI 1.18 至 1.92，p=0.001）和缺失社区药房信息（IRR 2.10，95%CI 1.64 至 2.68，p<0.001）与差异率显著相关。总体而言，20%（n=28）的患者有一个或多个高风险用药差异。
患者自行填写的用药史表差异率较高，应通过最佳用药史进行验证。
