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在护理过渡期间使用以保持用药连续性:一项观察性研究。

Using for medication continuity during transition of care: An observational study.

作者信息

Francis Martina, Francis Peter, Makeham Meredith, Baysari Melissa T, Patanwala Asad E, Penm Jonathan

机构信息

Department of Pharmacy, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.

Faculty of Medicine and Health, School of Pharmacy, University of Sydney, Sydney, New South Wales, Australia.

出版信息

Health Inf Manag. 2025 May;54(2):150-159. doi: 10.1177/18333583241270215. Epub 2024 Aug 26.

Abstract

National Personal Health Records (PHRs) have been proposed to improve the transfer of medication-related information during transition of care. To evaluate the concordance between the medications captured in the Australian national PHR, My Health Record (MyHR), and the pharmacist obtained best possible medication history (BPMH) for patients upon hospital admission. This prospective observational study used a convenience sample of hospital patients. For newly admitted patients, the investigating pharmacist obtained a BPMH and then compared it to the medication list captured in MyHR. Upon comparison, the medications were categorised into either complete match, partial match or mismatch. Medications with a complete or partial match were grouped together. Medications with deviations were then assessed for risk based on their potential consequence, and reported descriptively. A multivariable logistic regression was conducted to assess the factors associated with a drug being mismatched. A total of 82 patients were recruited, with a cumulative total of 1,207 medications documented. Of the 1,207 medications, 714 (59.2%) medications were documented as a complete/partial match. The remaining 493 (40.8%) medications were mismatched. Of the 493 mismatched medications, 442 (89.7%) were deemed low-risk deviations and 51 (10.3%) were deemed high-risk. A medication was more likely to be mismatched, rather than completely/partially matched, if it was a regular non-prescription medication, or "when-required" prescription medication, or "when required" non-prescription medication, or if it was administered parenterally. National PHRs may be a secondary source to either confirm a patient's medication history or be used as a starting point for a BPMH.

摘要

国家个人健康记录(PHR)已被提议用于改善医疗护理转接期间与药物相关信息的传递。目的是评估澳大利亚国家PHR(我的健康记录,MyHR)中记录的药物与药剂师为入院患者获取的最佳可能用药史(BPMH)之间的一致性。这项前瞻性观察性研究使用了医院患者的便利样本。对于新入院患者,调查药剂师获取BPMH,然后将其与MyHR中记录的药物清单进行比较。比较后,将药物分类为完全匹配、部分匹配或不匹配。完全匹配或部分匹配的药物归为一组。然后根据有偏差药物的潜在后果评估其风险,并进行描述性报告。进行多变量逻辑回归以评估与药物不匹配相关的因素。共招募了82名患者,记录的药物累计总数为1207种。在这1207种药物中,714种(59.2%)药物被记录为完全/部分匹配。其余493种(40.8%)药物不匹配。在493种不匹配的药物中,442种(89.7%)被视为低风险偏差,51种(10.3%)被视为高风险。如果药物是常规非处方药、“按需”处方药、“按需”非处方药或通过肠胃外给药,则该药物更有可能不匹配,而非完全/部分匹配。国家PHR可能是确认患者用药史的次要来源,也可作为BPMH的起点。

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