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与药物治疗相关的再入院:所涉药物的记录及连续护理中的沟通。

Medication-Related Readmissions: Documentation of the Medication Involved and Communication in the Care Continuum.

作者信息

Lee Ze-Yun, Uitvlugt Elien B, Karapinar-Çarkit Fatma

机构信息

Department of Clinical Pharmacy, OLVG, Amsterdam, Netherlands.

出版信息

Front Pharmacol. 2022 Mar 21;13:824892. doi: 10.3389/fphar.2022.824892. eCollection 2022.

Abstract

Of all readmissions, 21% are medication-related readmissions (MRRs). However, it is unknown whether MRRs are recognized at the time of readmission and are communicated in the care continuum. To identify the prevalence of MRRs that contain a documentation on the medication involved (and therefore are regarded as recognized), and the proportion of communicated MRRs. : The study was performed in a teaching hospital. In a previous study, a multidisciplinary team of physicians and pharmacists assessed the medication-relatedness, the medication involved and preventability of unplanned readmissions from seven departments. In the current cross-sectional study, two pharmacy team members evaluated the patient records independently. An MRR was regarded as recognized when the medication involved was documented in patient records. An MRR was regarded as communicated to the patient and/or the next healthcare provider when the medication involved or a description was mentioned in discharge letters or discharge prescriptions. The relationship between documented MRRs and whether the MRR was preventable as well as the relationship between (un)documented MRRs and the length of stay (LOS) were assessed. Descriptive data analysis was used. Of 181 included MRRs, 72 (40%) were deemed preventable by the multidisciplinary team. For 159 of 181 MRRs (88%), a documentation on the medication involved was present. Of 159 documented MRRs, 93 (58%) were communicated to patients and/or caregivers, 137 (86%) to the general practitioner, and 4 (3%) to the community pharmacy. The medication involved was documented less often for potentially preventable MRRs than for non-preventable MRRs (78 vs. 95%; = 0.002). The LOS was longer for MRRs where the medication involved was undocumented (median 8 vs. 5 days; = 0.062). The results of this study imply that MRRs are not always recognized, which could impact patients' well-being. In this study an increased LOS was observed with unrecognized MRRs. Communication of MRRs to the patients and/or the next healthcare providers should be improved.

摘要

在所有再入院病例中,21% 是与药物相关的再入院(MRR)。然而,尚不清楚在再入院时MRR是否被识别,以及是否在连续护理过程中进行了沟通。为了确定包含所涉药物记录(因此被视为已识别)的MRR的患病率,以及已沟通的MRR的比例。该研究在一家教学医院进行。在之前的一项研究中,一个由医生和药剂师组成的多学科团队评估了七个科室计划外再入院的药物相关性、所涉药物及可预防性。在当前的横断面研究中,两名药房团队成员独立评估患者记录。当患者记录中记录了所涉药物时,MRR被视为已识别。当出院信或出院处方中提及所涉药物或其描述时,MRR被视为已传达给患者和/或下一位医疗服务提供者。评估了记录的MRR与MRR是否可预防之间的关系,以及(未)记录的MRR与住院时间(LOS)之间的关系。采用描述性数据分析。在纳入的181例MRR中,多学科团队认为72例(40%)是可预防的。181例MRR中有159例(88%)存在所涉药物的记录。在159例有记录的MRR中,93例(58%)传达给了患者和/或护理人员,137例(86%)传达给了全科医生,4例(3%)传达给了社区药房。与不可预防的MRR相比,潜在可预防的MRR中所涉药物的记录较少(78%对95%;P = 0.002)。所涉药物未记录的MRR的住院时间更长(中位数8天对5天;P = 0.062)。本研究结果表明,MRR并非总能被识别,这可能会影响患者的健康。在本研究中,未识别的MRR观察到住院时间延长。应改善MRR与患者和/或下一位医疗服务提供者之间的沟通。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c50a/8978797/9c22af0a21e4/fphar-13-824892-g001.jpg

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