Barnett Nina L, Dave Krupa, Athwal Devinder, Parmar Paresh, Kaher Sunaina, Ward Christine
London North West Healthcare NHS Trust, London, UK.
Eur J Hosp Pharm. 2017 Nov;24(6):327-331. doi: 10.1136/ejhpharm-2016-000984. Epub 2016 Nov 1.
Medication contributes to 5-20% of hospital admissions, of which half are considered preventable. An integrated medicines management service (IMMS) was developed at a large general hospital in London to identify and manage patients at risk of a preventable medicines-related readmission (PMRR) to reduce the risk of PMRR.
To investigate the effect of the pharmacy IMMS on the rate of PMRR within 30 days of the first discharge.
744 patients were identified between October 2008 and October 2014, using the PREVENT tool. Patients at risk were managed by the IMMS with medication reconciliation, review, consultation and follow-up, as required.
Of 744 patients, 119 were readmitted within 30 days of discharge, with a PMRR for 2 patients (1.7%). The main reason for referral to the service was to assess the need to start a compliance aid. Most interventions involved communication: 84% included patient consultations with 50% involving discussion with the patient's community pharmacist and 32% with their general practitioner surgery.
An IMMS may be an effective method of reducing the rate of PMRR. Further work is needed to establish the cost-effectiveness of the service.
药物治疗导致5% - 20%的患者住院，其中一半被认为是可预防的。伦敦一家大型综合医院开发了一项综合药物管理服务（IMMS），以识别和管理有可预防的与药物相关再入院（PMRR）风险的患者，从而降低PMRR风险。
研究药房IMMS对首次出院后30天内PMRR发生率的影响。
2008年10月至2014年10月期间，使用PREVENT工具识别出744例患者。有风险的患者由IMMS根据需要进行药物重整、审查、咨询和随访管理。
744例患者中，119例在出院后30天内再次入院，2例（1.7%）发生PMRR。转诊至该服务的主要原因是评估启动依从性辅助工具的必要性。大多数干预措施涉及沟通：84%包括患者咨询，其中50%涉及与患者社区药剂师的讨论，32%涉及与患者全科医生诊所的讨论。
IMMS可能是降低PMRR发生率的有效方法。需要进一步开展工作以确定该服务的成本效益。
