Stuhec Matej
Faculty of Medicine Maribor, University of Maribor, Maribor, Slovenia.
Department of Clinical Pharmacy, Ormoz Psychiatric Hospital, Ormoz, Slovenia.
Int J Clin Pharm. 2025 Apr;47(2):239-246. doi: 10.1007/s11096-024-01840-9. Epub 2024 Dec 7.
Medication errors frequently happen during patients' transitions between different healthcare settings. Medication reconciliation, provided by various healthcare specialists, could help reduce these errors. However, clinical pharmacists do not lead this service nationally in most countries.
This paper describes the development, implementation, and national evaluation of medication reconciliation in Slovenia as part of seamless care.
All hospitals and community pharmacies in Slovenia.
The initial step involved the successful development of legislation in Slovenia. This process, termed 'seamless care,' was defined as a pharmaceutical service and five different steps of this process were developed: medication reconciliation upon admission (including the best possible medication history), during discharge, personal medication cards, and medication dispensing. A standard operational procedure was established in 2023 to guide these practices.
A critical milestone in the implementation process was establishing a successful reimbursement scheme in 2023. Hospitals and community pharmacies implemented this service following successful reimbursement. Pharmacy managers and heads of hospital pharmacy departments were responsible for overseeing its implementation in hospitals and community pharmacies. The Health Insurance Institute of Slovenia is measuring the implementation.
Trials were conducted in various Slovenian hospitals to evaluate this service's effectiveness, appropriateness, and adoption before its full implementation (reduced medication-related problems were observed). The Health Insurance Institute of Slovenia is currently evaluating the sustainability of the service and providing feedback to the providers.
Slovenia is the first country in this part of Europe to fully reimburse and implement medication reconciliation as a pharmaceutical service. This practice holds promise for exporting to other countries.
患者在不同医疗环境之间转换期间,用药错误频繁发生。由各类医疗专家提供的用药核对有助于减少这些错误。然而,在大多数国家,临床药师并未在全国范围内主导这项服务。
本文描述了斯洛文尼亚作为无缝医疗一部分的用药核对的发展、实施及全国评估情况。
斯洛文尼亚的所有医院和社区药房。
第一步涉及斯洛文尼亚成功制定立法。这一过程被称为“无缝医疗”,被定义为一项药学服务,并制定了该过程的五个不同步骤:入院时的用药核对(包括尽可能完善的用药史)、出院时的用药核对、个人用药卡以及药品调配。2023年制定了标准操作程序以指导这些实践。
实施过程中的一个关键里程碑是在2023年建立了成功的报销方案。医院和社区药房在报销成功后实施了这项服务。药房经理和医院药房部门负责人负责监督其在医院和社区药房的实施情况。斯洛文尼亚健康保险协会正在衡量实施情况。
在斯洛文尼亚的多家医院进行了试验,以在全面实施之前评估这项服务的有效性、适宜性和采用情况(观察到与用药相关的问题有所减少)。斯洛文尼亚健康保险协会目前正在评估该服务的可持续性,并向提供者提供反馈。
斯洛文尼亚是欧洲这一地区首个全面报销并实施用药核对作为一项药学服务的国家。这种做法有望向其他国家推广。