Pharmaceutical Service Department, Main Hospital, King Fahad Medical City, Riyadh, Saudi Arabia.
The Institute of Pharmaceutical Science (IPS) of University of Veterinary and Animal Sciences, Lahore, Pakistan.
PLoS One. 2022 Mar 15;17(3):e0265042. doi: 10.1371/journal.pone.0265042. eCollection 2022.
The purpose of this study was to assess the frequency and characteristics of discharge medication discrepancies as identified by pharmacists during discharge medication reconciliation. We also attempted to identify the factors that influence the occurrence of drug discrepancies during medication reconciliation. From June to December 2019, a prospective study was performed at the cardiac center of King Fahad Medical City (KFMC), a tertiary care hospital in Riyadh. The information from discharge prescriptions as compared to the medication administration record (MAR), medication history in the cortex system, and the patient home medication list collected from the medication reconciliation form on admission. The study included all adult patients discharged from KFMC's cardiac center. These participants comprised 776 patients, 64.6 percent of whom were men and 35.4 percent of whom were women. Medication discrepancies were encountered in 180 patients (23.2%) out of 776 patients. In regards to the number of discharged medications, 651(83.9%) patients had ≥ 5 medications. Around, 174 (73.4%) discrepancies were intentional, and 63 (26.6%) were unintentional discrepancies. The risk of unintentional medication discrepancy was increased with an increasing number of medications (P-value = 0.008). One out of every four cardiac patients discharged from our hospital had at least one medication discrepancy. The number of drugs taken and the number of discrepancies was found to be related. Necessary steps should be taken to reduce these discrepancies and improve the standard of care.
本研究旨在评估药师在出院药物重整期间发现的出院带药差异的频率和特征。我们还试图确定影响药物重整期间药物差异发生的因素。2019 年 6 月至 12 月，在利雅得三级护理医院法赫德国王医疗城（KFMC）的心脏中心进行了一项前瞻性研究。将出院处方与药物管理记录（MAR）、皮质系统中的用药史以及从入院时的药物重整表中收集的患者家庭用药清单进行比较。该研究纳入了从 KFMC 心脏中心出院的所有成年患者。这些参与者包括 776 名患者，其中 64.6%为男性，35.4%为女性。在 776 名患者中，有 180 名（23.2%）患者出现药物差异。就出院药物数量而言，651 名（83.9%）患者有≥5 种药物。大约 174 名（73.4%）差异是有意的，63 名（26.6%）是无意差异。随着用药数量的增加，无意药物差异的风险增加（P 值=0.008）。我们医院每四名出院的心脏病患者中就有一名至少有一种药物差异。服用的药物数量和差异数量呈相关关系。应采取必要措施减少这些差异，提高护理标准。
