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药物重整识别出急性冠状动脉综合征患者的用药差异。

Medication discrepancies identified by medication reconciliation among patients with acute coronary syndrome.

作者信息

Ataei Sara, Makki Behrouz, Ayubi Erfan, Emami Shahaboddin

机构信息

Department of Clinical Pharmacy, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran.

Cancer Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.

出版信息

Naunyn Schmiedebergs Arch Pharmacol. 2024 Oct;397(10):7649-7657. doi: 10.1007/s00210-024-03114-7. Epub 2024 May 2.

Abstract

Medication errors such as medication discrepancies are known as one of the leading cause of death. Medication discrepancies mostly occur during admission and at time transfer of care and discharge. Medication reconciliation process has pivotal role to avert medication discrepancies and improve patient safety and quality. Patients with acute coronary syndrome (ACS) are prone to medication discrepancies due to acute manifestations, simultaneous use of different medicines and having different co-morbidities. This study aimed to determine medication discrepancies identified by medication reconciliation among patients with ACS. In an observational study, patients with ACS admitted to a specialized Hospital in Baneh County, Kurdistan province during September 2023 and January 2024 were included. Medication reconciliation process was done when the patient was admitted. The history of medicine use was collected through interviews with the patient, their caregivers, as well as observing the medicines that were accompany with the patients. Number and type of unintentional medication discrepancies and related factors were evaluated. A total of 280 ACS patients (mean age: 63.8 ± 14.2, male gender: 59.3%) were included in the study. About 68% had at least 2 underlying diseases. The mean daily medicines taken by the patients during admission were 8.5 ± 1.54. The number (percentage) of unintentional inconsistency was observed in 78 (27.3%), and omission (39.7%) and changes in dosage (20.5%) had the highest frequency of unintentional medication discrepancies, respectively. Cardiovascular agents such as anti-dyslipidemia and antiplatelet had the highest frequency of unintentional medication discrepancies. The number of underlying diseases and daily medications before hospitalization increase the odds of discrepancies by 2.15 and 1.49 times, respectively (p-value < 0.05). Medication discrepancies identified by medication reconciliation among patients is relatively common. Unintentional medication discrepancies that have the potential to harm the ACS patients should be given more attention, especially in patients with multiple comorbidities and polypharmacy.

摘要

药物差错,如用药不符,是导致死亡的主要原因之一。用药不符大多发生在入院期间、转科和出院时。用药核对对于避免用药不符、提高患者安全性和医疗质量具有关键作用。急性冠状动脉综合征(ACS)患者由于急性症状、同时使用不同药物和患有不同合并症,容易出现用药不符。本研究旨在确定 ACS 患者用药核对中发现的用药不符。

在一项观察性研究中,纳入 2023 年 9 月至 2024 年 1 月期间入住库尔德斯坦省巴涅赫县一家专科医院的 ACS 患者。患者入院时进行用药核对。通过与患者、其护理人员面谈以及观察随患者携带的药物,收集用药史。评估用药不符的数量和类型及相关因素。

共有 280 例 ACS 患者(平均年龄:63.8±14.2,男性占 59.3%)纳入研究。约 68%的患者至少患有 2 种基础疾病。患者入院时平均每日服用的药物为 8.5±1.54 种。观察到 78 例(27.3%)存在非故意不一致,漏用(39.7%)和剂量改变(20.5%)的用药不符发生率最高。心血管药物如抗血脂异常和抗血小板药物的用药不符发生率最高。入院前的基础疾病数量和每日用药数量分别使不符的可能性增加 2.15 倍和 1.49 倍(p 值<0.05)。

用药核对中发现 ACS 患者存在相对常见的用药不符。对于有潜在危害 ACS 患者风险的非故意用药不符,应给予更多关注,尤其是患有多种合并症和多种药物治疗的患者。

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