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评估虚拟用药史技术员对用药重整差异的影响。

Assessing the impact of virtual medication history technicians on medication reconciliation discrepancies.

机构信息

Ascension Texas Department of Pharmacy, Austin, TX, USA.

University of Texas College of Pharmacy, Austin, TX, USA.

出版信息

Int J Clin Pharm. 2021 Oct;43(5):1404-1411. doi: 10.1007/s11096-021-01267-6. Epub 2021 Apr 19.

Abstract

Background To overcome resource limitations, Ascension hospitals have implemented a virtual pharmacy technician program to facilitate the completion of medication histories in select emergency departments. Objective This multicenter retrospective study aimed to assess the impact of taking a medication history virtually by pharmacy technicians on medication reconciliation accuracy in comparison to other clinicians. Setting Ascension Seton hospitals in Austin, Texas, United States. Method A retrospective chart review including patients above the age of 18, who were directly admitted from the emergency department between January 1, 2019 and August 31, 2019. Study investigators identified, quantified and categorized unintentional discrepancies by comparing medication histories to reconciled medication orders at admission. Descriptive analysis was applied to patient demographics. Mann-Whitney U and chi-square tests were applied to continuous and categorical outcomes, respectively. Main outcome measure The type and number of unintentional discrepancies at admission. Results In 208 patients, a total of 190 unintentional discrepancies were identified. The rate of unintentional discrepancies per medication was significantly lower for virtual pharmacy technicians than other clinicians (8.6% vs. 14.8% respectively, p < 0.0001). The most common type of unintentional discrepancies was omission in both groups. Length of stay, readmissions, and emergency department visits were similar in both groups. The rate of incomplete medication histories was significantly lower for virtual pharmacy technicians than other clinicians (6.7% vs. 62.5% respectively, p < 0.0001). Conclusion Implementing a virtual medication history technician program in the emergency department can revolutionize the medication history completion process and lower unintentional medication discrepancy rates.

摘要

背景

为克服资源限制,阿森松医院实施了虚拟药剂师计划,以促进在选定的急诊部门完成用药史。

目的

本多中心回顾性研究旨在评估药剂师虚拟采集用药史与其他临床医生相比对用药核对准确性的影响。

设置

美国德克萨斯州奥斯汀阿森松塞顿医院。

方法

一项回顾性图表审查,包括年龄在 18 岁以上,直接从急诊部门入院的患者,时间为 2019 年 1 月 1 日至 2019 年 8 月 31 日。研究调查人员通过比较入院时的用药史和核对后的用药医嘱,识别、量化和分类无意识差异。对患者人口统计学数据进行描述性分析。连续和分类结果分别应用 Mann-Whitney U 和卡方检验。

主要结果

在 208 名患者中,共发现 190 项无意识差异。虚拟药剂师组用药的无意识差异发生率明显低于其他临床医生(分别为 8.6%和 14.8%,p<0.0001)。两组中最常见的无意识差异类型均为遗漏。两组的住院时间、再入院率和急诊就诊率相似。虚拟药剂师组未完成用药史的比例明显低于其他临床医生(分别为 6.7%和 62.5%,p<0.0001)。

结论

在急诊部门实施虚拟用药史技师计划可以彻底改变用药史完成过程,降低无意识用药差异率。

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