Department of Pharmacy Practice, KLE College of Pharmacy, Belagavi, KLE Academy of Higher Education and Research Belagavi, Karnataka, India.
Curr Drug Saf. 2024;19(3):368-376. doi: 10.2174/1574886318666230911144912.
The study aimed to assess the impact of pharmacist interventions during the transition of care.
Medication discrepancies can occur at various levels of transition, such as during admission, the transition from emergency to special wards or from special to general wards, and during discharge. Discrepancies can be detected through the process of medication reconciliation.
The objective of the study was to compare discrepancies among patients exposed to pharmacist intervention groups and those who were not and assess the perception of healthcare professionals and patients towards integrating pharmacists in the transition care process.
A pharmacist-led interventional study was conducted for six months on patients above 18 years of age and either sex who were admitted to the emergency department, had chronic diseases, and subsequently transferred to another department (any). The patients were randomized into intervention and control groups. The pharmacist performed a medication reconciliation and medication review to identify discrepancies in every transition in both the groups, and then reported to the treating physician to resolve in the intervention group.
Among the 73 patients recruited in the study, 152 discrepancies were identified. The total discrepancies observed in the control and intervention groups were 78 (51.3%) and 74 (48.6%), respectively. The majority, 35.53%, were found during the transition from emergency to special wards. The physician, upon pharmacist recommendations, accepted and resolved 48 discrepancies in the intervention group. The healthcare professional acceptance rate of pharmacist interventions was 64.86%.
The transitions of care are at risk for errors due to medication discrepancies, and pharmacists could potentially identify and resolve discrepancies. Healthcare professionals and patients reported to be satisfied by the involvement of clinical pharmacists in the healthcare team.
本研究旨在评估药师干预在转科过程中的影响。
在转科过程中，如入院时、从急诊到专科病房或从专科病房到普通病房的转科过程中、以及出院时，可能会出现药物差异。可以通过药物重整过程发现差异。
本研究的目的是比较接受药师干预组和未接受药师干预组患者之间的差异，并评估医疗保健专业人员和患者对整合药师参与转科护理过程的看法。
一项为期六个月的药师主导的干预性研究，对象为年龄在 18 岁及以上、性别不限的急诊入院患者，且患有慢性病，随后转至其他科室（任何科室）。患者被随机分为干预组和对照组。药师对两组的每一次转科都进行药物重整和药物审查，以识别差异，并向主治医生报告以在干预组中解决。
在研究中招募的 73 名患者中，共发现 152 个差异。对照组和干预组的总差异分别为 78（51.3%）和 74（48.6%）。在从急诊到专科病房的转科过程中发现了最多的差异，占 35.53%。根据药师的建议，主治医生接受并解决了干预组中的 48 个差异。药师干预措施的医护人员接受率为 64.86%。
由于药物差异，转科过程存在发生错误的风险，而药师有可能识别并解决这些差异。医疗保健专业人员和患者报告称，临床药师参与医疗团队让他们感到满意。
