Dietrich Fine Michèle, Hersberger Kurt E, Arnet Isabelle
Pharmaceutical Science, Pharmaceutical Care Research Group, University of Basel, Basel, Switzerland.
Pharmaceutical Science, Pharmaceutical Care Research Group, University of Basel, Basel, Switzerland
BMJ Open. 2020 Oct 22;10(10):e037668. doi: 10.1136/bmjopen-2020-037668.
Particularly at transitions of care points information concerning current medication tends to be incomplete. A medication chart that contains all essential information on current therapy is likely to be a helpful tool for patients and healthcare providers. We aimed to investigate any type of benefits associated with medication charts provided at transition points.
A systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed. Two databases, two online journals and two association websites dedicated to biomedicine and pharmacy issues were consulted to identify studies for the review using the search term 'medication chart' and synonyms. We run our search from database inception up to March 2019. Studies of any study design, intervention and population which examined the effect of paper-based medication charts were included. We extracted study results narratively and coded and classified them by themes and categories inductively by using the 'framework method' with content analysis. The methodological quality of the studies was assessed using the Effective Public Health Practice Project (EPHPP) tool.
From the 846 retrieved articles, 30 studies met the inclusion criteria, mostly from Germany (18 studies) and the USA (5 studies). Thirteen studies reported a statistically significant result. In the 'patient theme', the most obvious benefits were an increase in medication knowledge, a reduction of medication errors and higher medication adherence. In the 'interdisciplinary theme', a medication chart represented a helpful tool to increase communication and inter-sectoral cooperation between healthcare providers. In the 'theme of terms and conditions', accuracy and currency of data are prerequisites for any positive effect. The quality of the studies was classified predominantly weak mainly due to unmet good quality criteria (no randomised controlled trials study design, no reported dropouts).
Overall, the reviewed studies suggested some benefits when using medication charts. Healthcare providers could consider using medication charts in their counselling practice. However, it is unknown whether the reported benefits lead to measurable improvement in clinical outcomes. PROSPERO REGISTRATION NUMBER.
尤其是在医疗护理转接点，有关当前用药的信息往往不完整。一份包含当前治疗所有基本信息的用药图表可能会成为对患者和医疗服务提供者都有帮助的工具。我们旨在调查在转接点提供用药图表所带来的任何类型的益处。
按照系统评价和Meta分析的首选报告项目（PRISMA）指南进行了一项系统评价。查阅了两个数据库、两个在线期刊以及两个专门讨论生物医学和药学问题的协会网站，以使用搜索词“用药图表”及其同义词来识别纳入评价的研究。我们从数据库建立之初到2019年3月进行了检索。纳入了任何研究设计、干预措施和人群的研究，这些研究考察了纸质用药图表的效果。我们采用叙述方式提取研究结果，并使用内容分析的“框架法”对其进行归纳编码和按主题及类别分类。使用有效公共卫生实践项目（EPHPP）工具评估研究的方法学质量。
从检索到的846篇文章中，有30项研究符合纳入标准，其中大部分来自德国（18项研究）和美国（5项研究）。13项研究报告了具有统计学意义的结果。在“患者主题”中，最明显的益处是用药知识增加、用药错误减少以及用药依从性提高。在“跨学科主题”中，用药图表是增进医疗服务提供者之间沟通和跨部门合作的有用工具。在“条款和条件主题”中，数据的准确性和时效性是产生任何积极效果的前提条件。这些研究的质量主要被归类为薄弱，主要原因是未达到良好质量标准（没有随机对照试验研究设计，没有报告失访情况）。
总体而言，纳入评价的研究表明使用用药图表有一些益处。医疗服务提供者可考虑在其咨询实践中使用用药图表。然而，所报告的益处是否会导致临床结局有可衡量的改善尚不清楚。PROSPERO注册号。
