Vogel Johannes B, Neyer Magdalena, Elsner Pascal, Vonbank Alexander, Plattner Thomas, Saely Christoph H, Leiherer Andreas, Drexel Heinz
Faculty of Medical Sciences, Private University in the Principality of Liechtenstein (UFL), 9495 Triesen, Liechtenstein.
Vorarlberg Institute for Vascular Investigation & Treatment (VIVIT), 6800 Feldkirch, Austria.
J Clin Med. 2024 May 29;13(11):3187. doi: 10.3390/jcm13113187.
A complete medication plan (MPlan) increases medication safety and adherence and is crucial in care transitions. Countries that implemented a standardized MPlan reported benefits on patients' understanding and handling of their medication. Austria lacks such a standardization, with no available data on the issue. This study aimed to investigate the current state of all medication documentations (MDocs) at hospital admission in a population at high risk for polypharmacy in Austria. We enrolled 512 consecutive patients undergoing elective coronary angiography. Their MDocs and medications were recorded at admission. MDocs were categorized, whereby a MPlan was defined as a tabular list including medication name, dose, route, frequency and patient name. Out of 485 patients, 55.1% had an MDoc (median number of drugs: 6, range 2-17), of whom 24.7% had unstructured documentation, 18.0% physicians' letters and 54.3% MPlans. Polypharmacy patients did not have a MDoc in 31.3%. Crucial information as the patients's name or the originator of the MDoc was missing in 31.1% and 20.4%, respectively. Patients with MDoc provided more comprehensive medication information ( = 0.019), although over-the-counter-medication was missing in 94.5% of MDocs. A discrepancy between the MPlan and current medication at admission existed in 64.4%. In total, only 10.7% of our patient cohort presented an MPlan that was in accordance with their current medication. The situation in Austria is far from a standardized MPlan generated in daily routine. Numerous MPlans do not represent the current medication and could pose a potential risk for the effectiveness and safety of pharmacotherapy.
完整的用药计划（MPlan）可提高用药安全性和依从性，在护理过渡中至关重要。实施标准化MPlan的国家报告了其对患者理解和处理药物方面的益处。奥地利缺乏这种标准化，且没有关于该问题的可用数据。本研究旨在调查奥地利多药合用高风险人群入院时所有用药记录（MDocs）的现状。我们纳入了512例连续接受择期冠状动脉造影的患者。在入院时记录他们的MDocs和用药情况。对MDocs进行分类，其中MPlan被定义为包含药物名称、剂量、给药途径、频率和患者姓名的表格清单。在485例患者中，55.1%有MDoc（药物中位数：6种，范围2 - 17种），其中24.7%为非结构化记录，18.0%为医生信件，54.3%为MPlans。31.3%的多药合用患者没有MDoc。分别有31.1%和20.4%的MDocs中缺少患者姓名或MDoc的开具者等关键信息。有MDoc的患者提供了更全面的用药信息（P = 0.019），尽管94.5%的MDocs中缺少非处方药信息。入院时MPlan与当前用药之间存在差异的情况占64.4%。总体而言，我们的患者队列中只有10.7%的MPlan与他们当前的用药情况相符。奥地利的情况远非日常工作中生成的标准化MPlan。许多MPlans并不代表当前用药情况，可能对药物治疗的有效性和安全性构成潜在风险。
