Imfeld-Isenegger Tamara L, Pham Melanie Bich Tram, Stämpfli Dominik, Albert Valerie, Almanasreh Enas, Moles Rebekah, Chen Timothy F, Hersberger Kurt E
Pharmaceutical Care Research Group, University of Basel, 4056 Basel, Switzerland.
Pharmacoepidemiology, Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, 8093 Zurich, Switzerland.
Pharmacy (Basel). 2020 Mar 9;8(1):36. doi: 10.3390/pharmacy8010036.
: Transitions of care are high-risk situations for the manifestation of medication discrepancies and, therefore, present threats for potential patient harm. Medication discrepancies can occur at any transition within the healthcare system. : Fifth-year pharmacy students assessed a best possible medication list (BPML) during a medication review (based on medication history and patient interview) in community pharmacies. They documented all discrepancies between the BPML and the latest medication prescription. Discrepancies were classified using the medication discrepancy taxonomy (MedTax) classification system and were assessed for their potential clinical and economic impact. Overall, 116 patients with a mean age and medication prescription of 74 (± 10.3) years and 10.2 (± 4.2), respectively, were analyzed. Of the 317 discrepancies identified, the most frequent type was related to strength and/or frequency and/or number of units of dosage form and/or the total daily dose. Although, the majority of discrepancies were rated as inconsequential (55.2%) on health conditions, the remainder posed a potential moderate (43.2%) or severe impact (1.6%). In 49.5% of the discrepancies, the current patients' medication cost less than the prescribed. : Community pharmacies are at a favorable place to identify discrepancies and to counsel patients. To improve patient care, they should systematically perform medication reconciliation whenever prescriptions are renewed or added.
医疗护理转接是出现用药差异的高风险情况,因此对患者构成潜在伤害威胁。用药差异可能发生在医疗系统内的任何转接环节。:五年级药学专业学生在社区药房进行用药评估(基于用药史和患者访谈)时,评估了最佳可能用药清单(BPML)。他们记录了BPML与最新用药处方之间的所有差异。使用用药差异分类法(MedTax)分类系统对差异进行分类,并评估其潜在的临床和经济影响。总体而言,共分析了116名患者,平均年龄和用药处方分别为74(±10.3)岁和10.2(±4.2)。在识别出的317处差异中,最常见的类型与剂型的强度和/或频率和/或单位数量和/或每日总剂量有关。尽管大多数差异在健康状况方面被评为无关紧要(55.2%),但其余差异构成潜在的中度(43.2%)或严重影响(1.6%)。在49.5%的差异中,当前患者的用药费用低于处方费用。:社区药房处于识别差异并为患者提供咨询的有利位置。为改善患者护理,每当处方更新或增加时,他们应系统地进行用药核对。