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与儿科出院处方取药相关的因素。

Factors Associated With Pickup of Pediatric Discharge Prescriptions.

作者信息

Lazar Abigail, Rappaport David I, Sharif Iman, Hossain Md Jobayer

机构信息

Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Divisions of General Pediatrics and

出版信息

Hosp Pediatr. 2019 Jun;9(6):440-446. doi: 10.1542/hpeds.2019-0023. Epub 2019 May 3.

Abstract

BACKGROUND AND OBJECTIVES

Lack of medication pickup is associated with worse clinical outcomes for select patients. Identification of risk factors for not picking up discharge medications or approaches to this problem have received little study. We sought to identify factors associated with medication pickup rates after hospitalization at a tertiary care children's hospital.

METHODS

We conducted a retrospective cohort study of 178 discharges from a children's hospital. We contacted pharmacies that received electronic prescriptions to ascertain whether patients and families picked up medications. The principal outcome was pickup of all medications within 48 hours of discharge. Covariates included demographic data, insurance type, discharge diagnosis, home zip code median income, medication number and/or class, and pharmacy type (on-site versus off-site). We performed a multivariable logistic regression analysis.

RESULTS

Overall, 142 of 178 (80%) discharges involved medication pickup. Patient age and sex, diagnosis, discharge day, primary language, and hospitalization length had no statistically significant association with medication pickup. On the multivariable analysis, a higher home zip code median income ( = .045; highest versus lowest groups) had a statistically significant association with increased medication pickup. Private insurance had a statistically significant association with higher pickup rate on the univariable analysis ( = .01) but not on the multivariable analysis, which included zip code income ( = .072). On-site pharmacy use ( = .048) and prescription of an anti-infective ( = .003) had statistically significant associations with higher medication pickup rates.

CONCLUSIONS

Certain factors are associated with rates of medication pickup after discharge. Use of an on-site hospital pharmacy may represent a strategy to improve medication pickup rates in children who are hospitalized.

摘要

背景与目的

对于部分患者而言,未取药与较差的临床结局相关。关于未取走出院带药的风险因素或针对此问题的解决方法的研究较少。我们试图确定一家三级儿童专科医院住院后与取药率相关的因素。

方法

我们对一家儿童医院的178例出院病例进行了回顾性队列研究。我们联系接收电子处方的药房,以确定患者及其家属是否取走了药物。主要结局是在出院后48小时内取走所有药物。协变量包括人口统计学数据、保险类型、出院诊断、家庭邮政编码所在区域的收入中位数、药物数量和/或类别以及药房类型(院内药房与院外药房)。我们进行了多变量逻辑回归分析。

结果

总体而言,178例出院病例中有142例(80%)涉及取药。患者的年龄、性别、诊断、出院日期、主要语言和住院时长与取药无统计学上的显著关联。在多变量分析中,家庭邮政编码所在区域较高的收入中位数(P = 0.045;最高组与最低组)与取药增加具有统计学上的显著关联。在单变量分析中,私人保险与较高的取药率具有统计学上的显著关联(P = 0.01),但在包含邮政编码收入的多变量分析中则无此关联(P = 0.072)。使用院内药房(P = 0.048)和开具抗感染药物处方(P = 0.003)与较高的取药率具有统计学上的显著关联。

结论

某些因素与出院后的取药率相关。使用院内医院药房可能是提高住院儿童取药率的一种策略。

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