Sørensen Charlotte Arp, Jeffery Linda, Falhof Jannik, Harbig Philipp, Roelsgaard Klaus, Gram Solveig, Olesen Charlotte
Hospital Pharmacy Central Denmark Region, Research & Development, Palle Juul-Jensens Boulevard 99, Aarhus N 8200, Denmark.
Research Centre for Patient Involvement, Aarhus University, Aarhus, Denmark.
Ther Adv Drug Saf. 2023 Mar 18;14:20420986231159221. doi: 10.1177/20420986231159221. eCollection 2023.
Healthcare is challenged by a rapidly growing group of patients with multi-morbidity and polypharmacy. Increasing activity and specialization puts pressure on healthcare sectors. Medication errors in cross-sectoral transition of patients are often seen. The aim of the study was to explore drug-related problems (DRPs) in the transition of patients between sectors and to develop and pilot-test a cross-sectoral hospital pharmacist intervention to overcome some of these problems.
DRPs in cross-sectoral transitions were explored from four perspectives; the literature, the primary and secondary healthcare sector and the patients. An intervention was developed from the findings through co-creation between pharmacists, doctors and a nurse. The intervention was piloted and evaluated from data on the included patients and the activities performed.
DRPs in transitions from general practice (GP) to hospital were caused by inadequate focus on updating the Shared Medication Record (SMR). For patients being discharged, DRPs were described with multiple facets; for example, missing information on medication changes, lacking patient involvement and problems with dose-dispensed medicine or electronic prescriptions. An intervention with a pharmacist in a shared employment between Hospital Pharmacy and GP was developed and piloted. The intervention included medication reconciliation and updating SMR for patients referred to hospital; and medication review, overview of medication changes and follow-up telephone calls for patients discharged from hospital. The intervention identified and solved several DRPs; in this way, medication errors were avoided. Access to health records in both sectors was important in the identification and resolution of DRPs.
DRPs in cross-sectoral transitions are multifaceted and the experiences depend on the point of view. The cross-sectoral hospital pharmacist intervention identified and solved several DRPs and medication errors were avoided. The intervention made sense to both healthcare sectors and patients. Shared employment and unique access to health records in both sectors showed to be of importance in the identification and resolution of DRPs.
Healthcare is challenged by a rapidly growing group of patients with multiple chronic diseases treated with several drugs at the same time. The aim of the study was to explore drug-related problems in the transition of patients between the hospital and patients' general practitioner and to develop and pilot-test a pharmacist intervention to overcome some of these problems. Drug-related problems in patient transitions were explored from the perspectives of the hospital, the general practitioner, the patients and the literature. An intervention was developed from the findings by pharmacists, doctors and a nurse. The intervention was pilot-tested and evaluated from the descriptions of the included patients and activities performed. Drug-related problems in transitions from general practice to hospital were caused by inadequate focus on updating the Shared Medication Record.For patients being discharged, drug-related problems were related to for examplemissing information on medication changessparse involvement of the patient in their own treatmentproblems with medicine dispensed on a dose dispensing machine at the local pharmacy.An intervention with a pharmacist in a shared employment between Hospital Pharmacy and general practice was developed and piloted. The intervention includedtalking to the patient about their medication and updating the Shared Medication Record for patients referred to hospitalmedication review, overview of medication changes and follow-up telephone calls for patients discharged from hospital to general practice.The intervention identified and solved several drug-related problems. Access to health records in both the general practice and at the hospital was important in the identification of drug-related problems. Drug-related problems in cross-sectoral transitions are multifaceted. The pharmacist intervention identified and solved several drug-related problems. The intervention made sense to the general practitioner, hospital and patients. Shared employment and unique access to health records in both the general practice and at the hospital showed to be of importance in the identification of drug-related problems.
医疗保健面临着越来越多患有多种疾病且服用多种药物的患者的挑战。活动增加和专业化给医疗保健部门带来了压力。患者跨部门转诊时的用药错误屡见不鲜。本研究的目的是探讨患者在部门间转诊过程中与药物相关的问题（DRP），并开发和试点一项跨部门医院药师干预措施，以克服其中一些问题。
从四个角度探讨跨部门转诊中的DRP，即文献、初级和二级医疗保健部门以及患者。根据研究结果，通过药剂师、医生和护士的共同创造制定了一项干预措施。根据纳入患者的数据和所开展的活动对该干预措施进行了试点和评估。
从全科医疗（GP）转诊至医院过程中的DRP是由于对更新共享用药记录（SMR）的关注不足所致。对于出院患者，DRP具有多个方面的描述，例如，用药变更信息缺失、患者参与度不够以及剂量配发药物或电子处方方面的问题。开发并试点了一项由医院药房和GP共同聘用药师的干预措施。该干预措施包括对转诊至医院的患者进行用药核对并更新SMR；对出院患者进行用药审查、用药变更概述以及随访电话。该干预措施识别并解决了若干DRP，从而避免了用药错误。两个部门均可访问健康记录对于识别和解决DRP很重要。
跨部门转诊中的DRP是多方面的，其情况取决于不同的视角。跨部门医院药师干预措施识别并解决了若干DRP，避免了用药错误。该干预措施对医疗保健部门和患者均有意义。两个部门的共同聘用以及对健康记录的独特访问权限在识别和解决DRP方面显示出重要性。
医疗保健面临着越来越多同时患有多种慢性病且服用多种药物的患者的挑战。本研究的目的是探讨患者在医院和患者的全科医生之间转诊过程中与药物相关的问题，并开发和试点一项药师干预措施以克服其中一些问题。从医院、全科医生、患者和文献的角度探讨了患者转诊过程中与药物相关的问题。根据药剂师、医生和护士的研究结果制定了一项干预措施。根据纳入患者的描述和所开展的活动对该干预措施进行了试点测试和评估。从全科医疗转诊至医院过程中的与药物相关的问题是由于对更新共享用药记录的关注不足所致。对于出院患者，与药物相关的问题包括例如用药变更信息缺失、患者在自身治疗中的参与度低、当地药房剂量配发机配发药物方面的问题。开发并试点了一项由医院药房和全科医疗共同聘用药师的干预措施。该干预措施包括与患者讨论其用药情况并为转诊至医院的患者更新共享用药记录、对出院患者进行用药审查、用药变更概述以及随访电话至全科医疗。该干预措施识别并解决了若干与药物相关的问题。全科医疗和医院均可访问健康记录对于识别与药物相关的问题很重要。跨部门转诊中的与药物相关的问题是多方面的。药师干预措施识别并解决了若干与药物相关的问题。该干预措施对全科医生、医院和患者均有意义。全科医疗和医院的共同聘用以及对健康记录的独特访问权限在识别与药物相关的问题方面显示出重要性。
