Cowley Emily, Miller Michael R, Yin Charles, Kelly Lynne
, PharmD, ACPR, was, at the time of this study, a Year I Pharmacy Resident at London Health Sciences Centre, London, Ontario. She is now a Pharmacist with Alberta Health Services, Edmonton, Alberta.
, PhD, is a Statistician with the Department of Paediatrics and the Children's Health Research Institute, Western University, London, Ontario.
Can J Hosp Pharm. 2021 Winter;74(1):15-20. Epub 2021 Jan 1.
Poor prescribing and incomplete medication administration have been linked to increased lengths of hospitalization for patients with Parkinson disease. The Institute for Safe Medication Practices (ISMP) has recommended that patients with Parkinson disease receive a pharmacy consultation within 2 h of admission to hospital.
To examine whether the time for a pharmacy team member to obtain a best possible medication history (BPMH) was associated with administration-related medication errors. The primary outcome was the proportion of doses with a medication error during a patient's admission in relation to the time to completion of the initial BPMH by a registered pharmacist (RPh) or registered pharmacy technician (RPhT). The secondary objective was to compare the proportion of doses with a medication error in relation to whether the BPMH was completed by an RPh or an RPhT.
This retrospective chart review involved patients with Parkinson disease who were admitted to the medicine services at London Health Sciences Centre from September 30, 2014, to September 30, 2018. Patients were included if they had Parkinson disease and a medication regimen that included levodopa-carbidopa. For all patients, an RPhT or RPh conducted the initial BPMH or updated the BPMH. Pearson correlation analysis was used to determine whether a correlation existed between administration-related errors and completion of the BPMH by a pharmacy staff member.
A total of 84 patients with 104 admissions were included. There was no significant correlation between the time to completion of the initial BPMH by a pharmacy team member and the proportion of doses with medication errors ( = 0.32). Although RPhTs completed the BPMHs more quickly than RPhs ( < 0.001), there was no significant difference between pharmacy team members in terms of the proportion of doses with medication errors ( = 0.86).
Completing a BPMH within 2 h of a patient's admission, as per the ISMP recommendation, is unlikely to affect administration-related medication errors, given that no correlation was identified. Expediting BPMH without addressing other factors is insufficient, and initiatives are required to improve the medication administration process.
帕金森病患者用药处方不当和用药不完整与住院时间延长有关。安全用药实践研究所（ISMP）建议帕金森病患者在入院后2小时内接受药学咨询。
探讨药学团队成员获取最佳用药史（BPMH）的时间是否与用药相关的给药错误有关。主要结局是患者住院期间与注册药剂师（RPh）或注册药房技术员（RPhT）完成初始BPMH的时间相关的给药错误剂量比例。次要目的是比较由RPh或RPhT完成BPMH的情况下给药错误剂量的比例。
这项回顾性病历审查涉及2014年9月30日至2018年9月30日入住伦敦健康科学中心内科的帕金森病患者。纳入标准为患有帕金森病且用药方案中包含左旋多巴-卡比多巴的患者。对于所有患者，由RPhT或RPh进行初始BPMH或更新BPMH。采用Pearson相关分析来确定给药相关错误与药学人员完成BPMH之间是否存在相关性。
共纳入84例患者，104次住院。药学团队成员完成初始BPMH的时间与给药错误剂量比例之间无显著相关性（ = 0.32）。尽管RPhT完成BPMH的速度比RPh快（ < 0.001），但药学团队成员在给药错误剂量比例方面无显著差异（ = 0.86）。
按照ISMP的建议，在患者入院后2小时内完成BPMH不太可能影响用药相关的给药错误，因为未发现相关性。在不解决其他因素的情况下加快BPMH是不够的，需要采取措施来改善用药过程。
