Lind Katrine Brodersen, Soerensen Charlotte Arp, Salamon Suheil Andreas, Jensen Tommy Midtgaard, Kirkegaard Hans, Lisby Marianne
Emergency Department, Randers Regional Hospital, Randers, Denmark.
Randers Department, Hospital Pharmacy Central Denmark Region, Randers, Denmark.
Eur J Hosp Pharm. 2016 May;23(3):171-176. doi: 10.1136/ejhpharm-2015-000767. Epub 2015 Dec 1.
Physicians in acute admission units (AAUs) are obliged to obtain medication history and perform medication reconciliation, which is time consuming and often incomplete. Studies show that clinical pharmacists (CPs) can obtain accurate medication histories, but so far no studies have investigated the effect of this on time measures. Therefore, the objective of the present study was to investigate the effect of a CP intervention on length of stay (LOS) in an AAU.
The study was designed as a prospective, cluster randomised study. Weekdays were randomised to control or intervention. CP intervention consisted of obtaining medication history and performing medication reconciliation and review. The primary outcome was LOS in the AAU. Secondary outcomes were other time-related measures-for example, physicians' self-reported time spent on medication topics. Finally, the number of documented medications per patient was established.
232 and 216 patients, respectively, were included on control (n=63) and intervention (n=63) days. The mean LOS was 342 (95% CI 323 to 362) min in the intervention group and 339 (95% CI 322 to 357) min in the control group, which was not statistically significantly different. Physicians spent on average 4.3 (95% CI 3.7 to 5.0) min in the intervention group and 7.5 (95% CI 6.6 to 8.5) min in the control group, corresponding to an overall reduction of 43.0% (95% CI 30.9% to 53.0%, p<0.001). The number of documented medications per patient was 10.0 (intervention group) and 8.8 (control group).
This study indicates that LOS in the AAU was not affected by CP intervention; however, physicians reported a significant reduction in time spent on medication topics.
Clinical Trial Gov: 1-16-02-379-13.
急性收治单元（AAU）的医生有义务获取用药史并进行用药核对，这既耗时又常常不完整。研究表明临床药师（CP）能够获取准确的用药史，但迄今为止尚无研究调查此举对时间指标的影响。因此，本研究的目的是调查临床药师干预对急性收治单元住院时间（LOS）的影响。
本研究设计为一项前瞻性整群随机研究。工作日被随机分为对照组或干预组。临床药师干预包括获取用药史、进行用药核对和审查。主要结局指标是急性收治单元的住院时间。次要结局指标是其他与时间相关的指标，例如医生自我报告的在用药相关话题上花费的时间。最后，确定每位患者记录的用药数量。
对照组（n = 63）和干预组（n = 63）分别纳入了232例和216例患者。干预组的平均住院时间为342（95%CI 323至362）分钟，对照组为339（95%CI 322至357）分钟，差异无统计学意义。干预组医生平均花费4.3（95%CI 3.7至5.0）分钟，对照组为7.5（95%CI 6.6至8.5）分钟，总体减少了43.0%（95%CI 30.9%至53.0%，p<0.001）。每位患者记录的用药数量干预组为10.0，对照组为8.8。
本研究表明，急性收治单元的住院时间不受临床药师干预的影响；然而，医生报告在用药相关话题上花费的时间显著减少。
Clinical Trial Gov: 1-16-02-379-13。
