Enver Cüneyd, Ertürk Şengel Buket, Sancar Mesut, Korten Volkan, Okuyan Betul
Marmara University, Faculty of Pharmacy, Department of Clinical Pharmacy, İstanbul, Türkiye.
Marmara University, Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, İstanbul, Türkiye.
Turk J Pharm Sci. 2023 Aug 22;20(4):210-217. doi: 10.4274/tjps.galenos.2022.08455.
To determine the prevalence and type of medication discrepancies and factors associated with unintentional discrepancies and identify the rate of hospital readmission and emergency service visit within 30 days after discharge among hospitalized patients with infectious diseases and receiving clinical pharmacist-led medication reconciliation during the coronavirus disease-2019 (COVID-19) pandemic.
This observational study was conducted in the internal medicine and infectious diseases wards of a tertiary university hospital between July 2020 and February 2021 among hospitalized adult patients with infectious diseases. Medication reconciliation service (including patient counseling) was provided in person or by telephone. The number and type of medication discrepancies detected during the medication reconciliation services, the acceptance rate of pharmacists' recommendation, and factors associated with having at least one unintentional medication discrepancy at admission were evaluated. At follow-up, hospital readmission and emergency service visit within 30 days after discharge were assessed by telephone.
Among 146 patients, 84 (57.5%) had at least one unintentional discrepancy at admission. Only three unintentional discrepancies were determined in three patients at hospital discharge. All the pharmacists' recommendations for medication discrepancies were accepted by the physicians. Having COVID-19 [odds ratio (OR): 2.25, 95% confidence interval (CI): 1.15-4.40; <0.05], being at a high risk for medication error (OR: 2.01, 95% CI: 1.03-3.92; <0.05), and higher number of medications used at home (OR: 1.41, 95% CI: 1.23-1.61; <0.001) were associated with having at least one unintentional discrepancy at admission. The rates of 30 day hospital readmission and admission to the emergency medical service were 12.3% and 15.8%, respectively.
Medication reconciliation service provided by in-person or by telephone was useful for detecting and solving unintentional medication discrepancies during the COVID-19 pandemic.
确定药物差异的患病率、类型以及与无意差异相关的因素，并确定2019冠状病毒病（COVID-19）大流行期间住院传染病患者出院后30天内再次入院和急诊就诊的发生率，这些患者接受了临床药师主导的药物重整。
本观察性研究于2020年7月至2021年2月在一所三级大学医院的内科和传染病病房对住院成年传染病患者进行。亲自或通过电话提供药物重整服务（包括患者咨询）。评估了药物重整服务期间检测到的药物差异的数量和类型、药师建议的接受率以及入院时至少有一处无意药物差异的相关因素。在随访中，通过电话评估出院后30天内再次入院和急诊就诊的情况。
在146例患者中，84例（57.5%）入院时至少有一处无意差异。出院时仅在3例患者中确定了3处无意差异。药师对药物差异的所有建议均被医生接受。患有COVID-19[优势比（OR）：2.25，95%置信区间（CI）：1.15 - 4.40；P<0.05]、存在高药物错误风险（OR：2.01，95%CI：1.03 - 3.92；P<0.05）以及在家中使用的药物数量较多（OR：1.41，95%CI：1.23 - 1.61；P<0.001）与入院时至少有一处无意差异相关。30天再次入院率和急诊就诊率分别为12.3%和15.8%。
在COVID-19大流行期间，亲自或通过电话提供的药物重整服务对于检测和解决无意药物差异是有用的。
