eHealth Institute, Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden.
Pharmaceutical Department, Region Kalmar County, Kalmar, Sweden.
Eur J Hosp Pharm. 2021 Nov;28(Suppl 2):e128-e133. doi: 10.1136/ejhpharm-2020-002492. Epub 2020 Nov 16.
The Lund Integrated Medicines Management model offers a systematic approach for individualising and optimising patient drug treatment. Clinical, economical and humanistic outcomes have been shown as well as results from the medication reconciliation process. There is a need also to describe the medication review process.
To describe the frequency and types of drug-related problems (DRPs) identified during medication reviews and to evaluate the actions of the pharmacists and the physicians regarding the identified DRPs.
Structured medication reviews were conducted by a multi-professional team on top of standard care for 719 patients in two internal medicine wards in a Swedish University Hospital. The medication reviews were studied retrospectively to classify DRPs and actions taken.
A total of 573 (80%) of patients had at least one actual DRP; an average of three DRPs per patient and in total 2164. Wrong drug and adverse drug reaction were the most common types of DRPs. The most frequent medication groups involved in DRPs were drugs for the cardiovascular system and the nervous system and the most frequent substances were warfarin, digoxin, furosemide and paracetamol. The 10 most common medications accounted for 27% of the actual DRPs. Of the identified DRPs, a total of 1740 (80%) were acted on. The three most common types of adjustments made were withdrawal of drug therapy, change of drug therapy and initiation of drug therapy. When the pharmacist suggested an adjustment, the physician implemented 88% (1037/1174) of the recommendations.
DRPs are common among elderly patients who are admitted to hospital. Systematic identification of high-risk medications and common DRP types enables targeting of prioritised patients for medication reviews.
Lund 综合药物管理模式提供了一种个体化和优化患者药物治疗的系统方法。已经证明了临床、经济和人文方面的结果，以及药物重整过程的结果。还需要描述药物审查过程。
描述药物审查过程中发现的药物相关问题（DRP）的频率和类型，并评估药剂师和医生对确定的 DRP 采取的行动。
在瑞典一所大学医院的两个内科病房，一个多专业团队在标准护理的基础上对 719 名患者进行了结构化药物审查。对药物审查进行了回顾性研究，以对 DRP 和采取的行动进行分类。
共有 573 名（80%）患者至少有一种实际的 DRP；每位患者平均有三个 DRP，共 2164 个。药物错误和药物不良反应是最常见的 DRP 类型。涉及 DRP 的最常见药物组是心血管系统和神经系统的药物，最常见的物质是华法林、地高辛、呋塞米和扑热息痛。10 种最常见的药物占实际 DRP 的 27%。已确定的 DRP 中，共有 1740 个（80%）得到处理。最常见的三种调整类型是停止药物治疗、改变药物治疗和开始药物治疗。当药剂师建议调整时，医生实施了 88%（1037/1174）的建议。
住院老年患者中 DRP 很常见。系统地识别高危药物和常见的 DRP 类型，可以针对药物审查的优先患者进行靶向治疗。
