Clinical Pharmacy, Saarland University, Campus C2.2, 66123, Saarbruecken, Germany.
Klinikum Saarbruecken gGmbH, Clinic for Internal Medicine (I), Winterberg 1, 66119, Saarbruecken, Germany.
Res Social Adm Pharm. 2020 Oct;16(10):1370-1378. doi: 10.1016/j.sapharm.2020.01.013. Epub 2020 Jan 27.
Medication plans are instruments used to document drug therapies, guide patients, and ensure medication safety. In Germany, patients who take at least 3 long-term medications are eligible to receive a medication plan. It has been statutory to use the federal standard layout (German: "Bundeseinheitlicher Medikationsplan") since April 2017.
This study explores the prevalence, availability, medication discrepancies, and conformance with statutory regulations of medication plans since the introduction of the format of the federal standard medication plan in Germany.
Medication reconciliation was performed for hospitalized patients according to the Best Possible Medication History principle. The collected medication lists were analyzed for medication discrepancies and conformance with the statutory regulations. The medication discrepancies were (1) omitted drugs, (2) additional drugs, and (3) dosing errors.
After hospitalization, 524 patients taking drugs were included. The majority (n = 424 patients) were eligible for a medication plan. While 241 medication lists were present, only 24.1% (n = 58) matched the federal standard format. The mean number of drugs was 6.3 ± 3.6, with 3315 medications (3046 long-term and 269 as needed) reconciled totally. The 84 medication lists with omitted or additional drugs included 166 medication discrepancies upon 774 drugs listed. Of the 253 patients with dosing errors, 146 had a medication list. Inappropriate dosages were due to single dose (n = 195), daily dose (n = 225) or frequency of application (n = 255).
Medication plans are valuable tools for patients and health care providers. This study shows that the introduced paper-based federal standard medication plan in Germany falls short of its expectations regarding availability and correctness. Switching to an electronic patient record system may overcome some of the current pitfalls.
用药计划是记录药物治疗、指导患者和确保用药安全的工具。在德国，至少服用 3 种长期药物的患者有资格获得用药计划。自 2017 年 4 月以来，使用联邦标准布局（德语：“Bundeseinheitlicher Medikationsplan”）已成为法定要求。
本研究探讨了自德国引入联邦标准用药计划格式以来，用药计划的流行率、可用性、用药差异以及与法定规定的符合情况。
根据最佳药物史原则对住院患者进行用药核对。对收集的用药清单进行分析，以确定用药差异和是否符合法定规定。用药差异包括（1）遗漏药物、（2）额外药物和（3）剂量错误。
住院后共纳入 524 名服用药物的患者。大多数（n=424 名）患者有资格获得用药计划。虽然有 241 份用药清单，但只有 24.1%（n=58）符合联邦标准格式。平均用药数为 6.3±3.6，共核对 3315 种药物（3046 种为长期用药，269 种为按需用药）。在 84 份遗漏或额外药物的用药清单中，有 166 种药物存在 774 种列出的药物差异。在 253 名有剂量错误的患者中，有 146 名患者有用药清单。剂量不当是由于单次剂量（n=195）、每日剂量（n=225）或应用频率（n=255）引起的。
用药计划是患者和医疗保健提供者的有价值工具。本研究表明，在德国引入的纸质联邦标准用药计划在可用性和正确性方面未能达到预期。转向电子患者记录系统可能会克服当前的一些缺陷。
