Mathiesen Liv, Nguyen Tram Bich Michelle, Dæhlen Ingrid, Mowé Morten, Lea Marianne
Department of Pharmacy, Section for Pharmacology and Pharmaceutical Biosciences, University of Oslo, Postboks 1068 Blindern, 0316 Oslo, Norway.
Department of Mathematics, University of Oslo, Postboks 1053 Blindern, 0316 Oslo, Norway.
Int J Qual Health Care. 2024 Dec 5;36(4). doi: 10.1093/intqhc/mzae100.
High-quality discharge information is important to promote patient safety when patients are transferred from hospital to primary care. Patients with multiple long-term conditions are especially vulnerable to insufficient transfer of medication information, as they use many medications and have complex interactions with the healthcare services. The aim of this study was to investigate the effect of integrated medicines management provided to hospitalized multimorbid patients on the quality of the discharge medication information.
Multimorbid patients ≥18 years, using a minimum of four regular medications from a minimum of two therapeutic medication classes were recruited from the Internal Medicine ward, Oslo University Hospital, Norway, from August 2014 to March 2016 and randomly assigned, 1:1, to the intervention or control group. Intervention patients received integrated medicines management throughout the hospital stay. Control patients received standard care. This paper reports the results of a prespecified secondary endpoint analysis of the randomized controlled trial; the difference between the intervention and control group in the quality of discharge medication information.
The analysis population comprised 384 patients. Integrated medicines management improved the discharge summary quality score of the medication information from 5.8 ± 1.5 to 8.6 ± 2.6 [mean difference 2.7, 95% confidence interval (CI) 2.3-3.2, P < .001]. In total, 171 intervention patients (89%) received a patient discharge information letter, compared to 66 control patients (35%), P < .001. The quality score of the medication information in the patient discharge information letter was improved from 6.0 ± 1.8 in the control group to 10.0 ± 1.3 in the intervention group (mean difference 4.0, 95% CI 3.6-4.4, P < .001).
Integrated medicines management delivered to multimorbid patients during a hospital stay improved the quality of the medication information in discharge summaries as well as patient discharge information letters and ensured that a discharge information letter in lay language was prepared for almost all patients who were involved in the management of their medications after discharge.
当患者从医院转至初级保健机构时，高质量的出院信息对于促进患者安全至关重要。患有多种长期疾病的患者尤其容易受到药物信息传递不足的影响，因为他们使用多种药物，并且与医疗服务存在复杂的相互作用。本研究的目的是调查为住院的多病患者提供综合药物管理对出院药物信息质量的影响。
2014年8月至2016年3月，从挪威奥斯陆大学医院内科病房招募年龄≥18岁、至少使用两种治疗药物类别中的四种常规药物的多病患者，并将其按1:1随机分配至干预组或对照组。干预组患者在整个住院期间接受综合药物管理。对照组患者接受标准护理。本文报告了一项随机对照试验预先指定的次要终点分析结果；干预组和对照组在出院药物信息质量方面的差异。
分析人群包括384名患者。综合药物管理将药物信息的出院小结质量评分从5.8±1.5提高到8.6±2.6[平均差异2.7，95%置信区间（CI）2.3 - 3.2，P <.001]。总共有171名干预组患者（89%）收到了患者出院信息函，而对照组有66名患者（35%）收到，P <.001。患者出院信息函中药物信息的质量评分从对照组的6.0±1.8提高到干预组的10.0±1.3（平均差异4.0，95% CI 3.6 - 4.4，P <.001）。
在住院期间为多病患者提供综合药物管理可提高出院小结以及患者出院信息函中的药物信息质量，并确保为几乎所有出院后参与药物管理的患者准备了通俗易懂的出院信息函。
