Pharmacie, Hospices Civils de Lyon, Lyon, France.
Institut des Sciences Pharmaceutiques et Biologiques, Univ Claude Bernard Lyon 1, Univ Lyon 1, Lyon, France.
J Clin Pharm Ther. 2022 Jul;47(7):956-963. doi: 10.1111/jcpt.13627. Epub 2022 Feb 26.
The orthogeriatric path (hip-fractured elderly patients) is composed of several transition points (emergency surgery, orthopaedic, geriatric and rehabilitation units). The intervention of clinical pharmacists can ensure the continuity of patients' drug management during their hospital stay. The aim of the study was to assess the implementation of clinical pharmacy activities in an orthogeriatric pathway, regarding its impact on medication error prevention, the healthcare professionals' and patients' satisfaction, and the estimated associated pharmaceutical workload.
Participants were aged 75 or older and managed for proximal femoral fracture. Their admission prescription was reviewed. If they were evaluated at high risk of adverse event (AE), medication reconciliation (MedRec) and pharmaceutical interviews (admission, discharge, and targeted on oral anticoagulant) were added at different steps of their care pathway. The achievement and duration of each clinical pharmacy activity were recorded. The number of pharmaceutical interventions (PI) made during prescription review, and unintentional discrepancies (UID) identified during MedRec were collected. A satisfaction questionnaire was sent to patients and healthcare professionals.
Among 455 included patients, 284 patients were considered at high risk of AE. Clinical pharmacy activity achievement rates varied between 12% and 98%. A total of 622 PI and 333 UID were identified. The overall patients' and healthcare professionals' satisfaction was rated from 63% to 100%. The total workload was estimated at 376 h: on average 16 min per prescription review, 43 min per admission MedRec, 26 min per discharge MedRec and 17 to 25 minutes per interview.
The implementation of the programme showed a high potential of drug management securing. To sustain it, additional pharmaceutical human resources and high-performance computing tools are needed.
矫形老年病学路径（髋部骨折老年患者）由多个过渡点（急诊手术、矫形科、老年科和康复科）组成。临床药师的干预可以确保患者在住院期间药物管理的连续性。本研究旨在评估矫形老年病学路径中临床药学活动的实施情况，以及其对预防用药错误、医疗保健专业人员和患者满意度的影响，以及估计相关的药学工作量。
参与者年龄在 75 岁或以上，因股骨近端骨折接受治疗。对他们的入院处方进行了审查。如果他们被评估为有不良事件（AE）风险，则在他们的护理路径的不同阶段添加药物重整（MedRec）和药物咨询（入院、出院和针对口服抗凝剂）。记录了每项临床药学活动的完成情况和持续时间。在处方审查期间收集了药物干预（PI）的数量和药物重整期间发现的非故意差异（UID）。向患者和医疗保健专业人员发送了满意度问卷。
在 455 名纳入的患者中，284 名患者被认为有 AE 风险。临床药学活动的完成率在 12%至 98%之间。共发现 622 项 PI 和 333 项 UID。总体患者和医疗保健专业人员的满意度评分从 63%到 100%不等。总工作量估计为 376 小时：平均每次处方审查 16 分钟，每次入院 MedRec 43 分钟，每次出院 MedRec 26 分钟，每次咨询 17 至 25 分钟。
该方案的实施显示了药物管理保障的高潜力。为了维持这一方案，需要额外的药学人力资源和高性能计算工具。
