用药差异检测服务：一种具有成本效益的多学科临床方法。

The medication discrepancy detection service: A cost-effective multidisciplinary clinical approach.

作者信息

Oñatibia-Astibia Ainhoa, Malet-Larrea Amaia, Mendizabal Amaia, Valverde Elena, Larrañaga Belen, Gastelurrutia Miguel Ángel, Ezcurra Martín, Arbillaga Leire, Calvo Begoña, Goyenechea Estibaliz

机构信息

Official Pharmacist Association of Gipuzkoa, Prim 2, 20006 Donostia/San Sebastian, Spain; Pharmaceutical Technology Department, Faculty of Pharmacy, University of the Basque Country, UPV/EHU, P. Universidad 7, 01006 Vitoria, Spain.

Official Pharmacist Association of Gipuzkoa, Prim 2, 20006 Donostia/San Sebastian, Spain.

出版信息

Aten Primaria. 2021 Jan;53(1):43-50. doi: 10.1016/j.aprim.2020.04.008. Epub 2020 Sep 29.

DOI:10.1016/j.aprim.2020.04.008

PMID:32994060

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7752972/

Abstract

OBJECTIVE

To estimate the effectiveness of a Medication Discrepancy Detection Service (MDDS), a collaborative service between the community pharmacy and Primary Care.

DESIGN

Non-controlled before-and-after study.

SETTING

Bidasoa Integrated Healthcare Organisation, Gipuzkoa, Spain.

PARTICIPANTS

The service was provided by a multidisciplinary group of community pharmacists (CPs), general practitioners (GPs), and primary care pharmacists, to patients with discrepancies between their active medical charts and medicines that they were actually taking.

OUTCOMES

The primary outcomes were the number of medicines, the type of discrepancy, and GPs' decisions. Secondary outcomes were time spent by CPs, emergency department (ED) visits, hospital admissions, and costs.

RESULTS

The MDDS was provided to 143 patients, and GPs resolved discrepancies for 126 patients. CPs identified 259 discrepancies, among which the main one was patients not taking medicines listed on their active medical charts (66.7%, n=152). The main GPs' decision was to withdraw the treatment (54.8%, n=125), which meant that the number of medicines per patient was reduced by 0.92 (9.12±3.82 vs. 8.20±3.81; p<.0001). The number of ED visits and hospital admissions per patient were reduced by 0.10 (0.61±.13 vs 0.52±0.91; p=.405 and 0.17 (0.33±0.66 vs. 0.16±0.42; p=.007), respectively. The cost per patient was reduced by €444.9 (€1003.3±2165.3 vs. €558.4±1273.0; p=.018).

CONCLUSION

The MDDS resulted in a reduction in the number of medicines per patients and number of hospital admissions, and the service was associated with affordable, cost-effective ratios.

摘要

目的

评估药物差异检测服务（MDDS）的有效性，该服务是社区药房与初级保健之间的一项协作服务。

设计

非对照前后研究。

地点

西班牙吉普斯夸省比达索阿综合医疗保健组织。

参与者

该服务由一组多学科的社区药剂师（CP）、全科医生（GP）和初级保健药剂师提供给其现行病历与实际服用药物存在差异的患者。

结果

主要结果为药物数量、差异类型和全科医生的决定。次要结果为社区药剂师花费的时间、急诊就诊次数、住院次数和费用。

结果

MDDS服务提供给了143名患者，全科医生为126名患者解决了差异问题。社区药剂师识别出259处差异，其中主要差异是患者未服用现行病历上列出的药物（66.7%，n = 152）。全科医生的主要决定是停止治疗（54.8%，n = 125），这意味着每位患者的药物数量减少了0.92（从9.12±3.82降至8.20±3.81；p <.0001）。每位患者的急诊就诊次数和住院次数分别减少了0.10（从0.61±0.13降至0.52±0.91；p = 0.405）和0.17（从0.33±0.66降至0.16±0.42；p = 0.007）。每位患者的费用减少了444.9欧元（从1003.3±2165.3欧元降至558.4±1273.0欧元；p = 0.018）。