Department of Pharmacy, Royal Prince Alfred Hospital, Australia.
Royal Prince Alfred Virtual Hospital, Sydney Local Health District, Australia.
Res Social Adm Pharm. 2024 Dec;20(12 Pt A):1125-1133. doi: 10.1016/j.sapharm.2024.09.003. Epub 2024 Sep 12.
Unintended discrepancy in medications at the time of discharge from the hospital is associated with an increased incidence of adverse drug events, including readmission to hospital. Medication literacy is an essential part of health literacy and can reduce medication discrepancies. This prospective observational cohort study aimed to measure the medication literacy of patients at the time of discharge from the hospital when managed with usual care and after the introduction of a medication literacy improvement instrument. This study involved a baseline cohort receiving usual care and a post-intervention cohort aged 50-80 years with high health literacy. The 7 Things I Should Know About My Medications at the Time of Discharge from Hospital instrument, in short, The 7 Domains MedLit Instrument, was designed by the researchers in addition to three medication literacy measurement questionnaires. Medication literacy was measured at 30 h post-discharge. The impact on readmission to hospital was assessed at 30 days post-discharge. The 7 Domains MedLit Instrument was found to significantly increase the number of patients reporting increased counselling by a clinician at the time of discharge from the hospital (clinician, 59.3 % vs. 100.0 %, X (1, n = 49) = 11.10, p < 0.01, physician, 28.6 % vs. 76.2, X (1, n = 49) = 10.9, p < 0.01, pharmacist 25.0 % vs. 71.4 %, X (1, n = 49) = 10.4, p < 0.01)). Significantly, more patients had increased knowledge on drug interactions or adverse drug reactions after using the instrument (26.1 % vs. 61.9 %, P = 0.032 and 30.4 % vs. 66.7 %, P = 0.033, respectively). The 7 Domains MedLit Instrument and the schooling years significantly correlated with the knowledge of drug interactions and adverse drug reactions. Less post-intervention participants visited an emergency department within 30 days post-discharge. The 7 Domains MedLit Instrument significantly improved the patients' medication literacy at the time of discharge from hospital.
出院时药物使用方面的非预期差异与不良药物事件的发生率增加有关，包括再次住院。药物知识是健康素养的重要组成部分，可减少药物差异。这项前瞻性观察性队列研究旨在测量在常规护理管理下和引入药物知识改善工具后，患者在出院时的药物知识。这项研究涉及一个接受常规护理的基线队列和一个年龄在 50-80 岁、具有较高健康素养的干预后队列。除了三个药物知识测量问卷外，研究人员还设计了《出院时我应了解的 7 件关于我的药物的事情》工具，简称《7 个药物领域知识工具》。在出院后 30 小时测量药物知识，在出院后 30 天评估再入院情况。研究发现，《7 个药物领域知识工具》显著增加了报告出院时临床医生增加咨询的患者数量（临床医生，59.3%对 100.0%，X（1，n=49）=11.10，p<0.01，医师，28.6%对 76.2%，X（1，n=49）=10.9，p<0.01，药剂师，25.0%对 71.4%，X（1，n=49）=10.4，p<0.01）。使用该工具后，更多的患者在药物相互作用或药物不良反应方面的知识增加（分别为 26.1%对 61.9%，P=0.032 和 30.4%对 66.7%，P=0.033）。《7 个药物领域知识工具》和受教育年限与药物相互作用和药物不良反应的知识显著相关。干预后，较少的参与者在出院后 30 天内到急诊就诊。《7 个药物领域知识工具》显著提高了患者在出院时的药物知识。
