Clarenne Justine, Gravoulet Julien, Chopard Virginie, Rouge Julia, Lestrille Amélie, Dupuis François, Aubert Léa, Malblanc Sophie, Barbe Coralie, Slimano Florian, Mongaret Céline
Faculty of Pharmacy, Université de Reims Champagne-Ardenne, 51 Rue Cognacq-Jay, 51100 Reims, France.
Department of Pharmacy, CHU Reims, Rue du Général Koenig, 51100 Reims, France.
Pharmacy (Basel). 2021 Dec 23;10(1):2. doi: 10.3390/pharmacy10010002.
During the dispensing process of medical orders (MOs), community pharmacists (CPs) can manage drug-related problems (DRPs) by performing pharmacist interventions (PIs). There is little evidence that the PI rate is higher with MOs from hospitals (MOHs) than ambulatory (MOAs) settings, and their impact on the patient and community pharmacy is unknown. The primary objective of this study was to compare the MOH and MOA PI rates. The secondary objective was to describe PIs and their clinical and organizational impacts on patient and community pharmacy workflow. A total of 120 CPs participated in a prospective study. Each CP included 10 MOH and 10 MOA between January and June 2020. DRP and PI description and clinical and organizational impacts between MOH and MOA were assessed and compared. We analyzed 2325 MOs. PIs were significantly more frequent in MOH than in MOA (9.7% versus 4.7%; < 0.001). The most reported PI was the difficulty of contacting hospital prescribers (n = 45; 52.2%). MOHs were associated with a longer dispensing process time and a greater impact on patient pathway and community pharmacy workflow than MOAs. Lack of communication between hospital and primary care settings partly explains the results. Implementation of clinical pharmacy activities at patient discharge could alleviate these impacts.
在医嘱配药过程中，社区药剂师可通过开展药剂师干预措施来处理与药物相关的问题。几乎没有证据表明来自医院的医嘱的药剂师干预率高于门诊医嘱，而且其对患者和社区药房的影响尚不清楚。本研究的主要目的是比较医院医嘱和门诊医嘱的药剂师干预率。次要目的是描述药剂师干预措施及其对患者和社区药房工作流程的临床和组织影响。共有120名社区药剂师参与了一项前瞻性研究。每位药剂师在2020年1月至6月期间纳入10份医院医嘱和10份门诊医嘱。对医院医嘱和门诊医嘱之间的药物相关问题及药剂师干预措施的描述以及临床和组织影响进行了评估和比较。我们分析了2325份医嘱。医院医嘱的药剂师干预明显比门诊医嘱更频繁（9.7%对4.7%；<0.001）。最常报告的药剂师干预是联系医院开处方者困难（n = 45；52.2%）。与门诊医嘱相比，医院医嘱的配药过程时间更长，对患者就医途径和社区药房工作流程的影响更大。医院与基层医疗单位之间缺乏沟通在一定程度上解释了这些结果。在患者出院时开展临床药学活动可减轻这些影响。
