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药师主导的出院干预措施:对显示再入院率降低的研究的范围综述

Pharmacist-led interventions at hospital discharge: a scoping review of studies demonstrating reduced readmission rates.

作者信息

Weber Carole, Meyer-Massetti Carla, Schönenberger Nicole

机构信息

Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital-Bern University Hospital, 3010, Bern, Switzerland.

Institute of Primary Healthcare BIHAM, University of Bern, 3012, Bern, Switzerland.

出版信息

Int J Clin Pharm. 2025 Feb;47(1):15-30. doi: 10.1007/s11096-024-01821-y. Epub 2024 Dec 9.

Abstract

BACKGROUND

Substantial numbers of hospital readmissions occur due to medication-related problems. Pharmacists can implement different interventions at hospital discharge that aim to reduce those readmissions. It is unclear which pharmacist-led interventions at hospital discharge are the most promising in reducing readmissions.

AIM

This scoping review aimed to summarise pharmacist-led interventions conducted at hospital discharge that demonstrated a reduction in readmissions.

METHOD

We searched the MEDLINE, EMBASE and CINAHL databases up to February 2024. We included studies that focused on pharmacist-led interventions at hospital discharge and reported significant readmission reductions. Two reviewers independently screened titles, abstracts and full texts. Data extracted included study characteristics, populations and the type of implemented pharmacist-led interventions along with the reduction in readmission rates achieved.

RESULTS

We included 25 articles for data synthesis. Many of the studies included either implemented at least two interventions concurrently or were part of broader programmes involving other healthcare professionals. The most common pharmacist-led interventions associated with reduced readmission rates included medication reconciliation, counselling and post-discharge follow-up by telephone. Follow-up primarily aimed to improve patients' treatment adherence through education about their medications. Furthermore, many studies reported on multi-component interventions that began at hospital admission or during inpatient stays, not only at discharge.

CONCLUSION

Successfully reducing readmissions through pharmacist-led interventions at hospital discharge suggests the effectiveness of a holistic approach incorporating multiple interventions. While these findings offer insights for pharmacists, further research should focus on conducting high-quality studies using a multifaceted approach to identify the most appropriate timing and combination.

摘要

背景

大量的医院再入院是由与药物相关的问题导致的。药剂师可以在出院时实施不同的干预措施,旨在减少这些再入院情况。目前尚不清楚哪种由药剂师主导的出院干预措施在减少再入院方面最有前景。

目的

本范围综述旨在总结在出院时由药剂师主导的、已证明能减少再入院的干预措施。

方法

我们检索了截至2024年2月的MEDLINE、EMBASE和CINAHL数据库。我们纳入了关注出院时由药剂师主导的干预措施并报告了再入院显著减少的研究。两名评审员独立筛选标题、摘要和全文。提取的数据包括研究特征、人群、实施的由药剂师主导的干预措施类型以及实现再入院率的降低情况。

结果

我们纳入了25篇文章进行数据综合分析。许多研究要么同时实施了至少两种干预措施,要么是涉及其他医疗保健专业人员的更广泛项目的一部分。与再入院率降低相关的最常见的由药剂师主导的干预措施包括药物重整、咨询和出院后电话随访。随访主要旨在通过对患者进行用药教育来提高其治疗依从性。此外,许多研究报告了在入院时或住院期间开始的多成分干预措施,而不仅仅是在出院时。

结论

通过出院时由药剂师主导的干预措施成功减少再入院表明采用多种干预措施的整体方法是有效的。虽然这些发现为药剂师提供了见解,但进一步的研究应侧重于使用多方面方法进行高质量研究,以确定最合适的时机和组合。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3633/11741998/6dbf4137aacd/11096_2024_1821_Fig1_HTML.jpg

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