Al Mubarak Bushra, Elmasry Lamiaa Nehad, Qoronfulah Matuk, AlOtaibi Bodour, Abid Muhammad Hasan, AlOsaimy Dakhelullah, Hawsawi Ammar, AlShehri Faris
Pharmaceutical Care, Al-Hada Armed Forces Hospital, Taif, Saudi Arabia
Continuous Quality Improvement & Patient Safety, Al-Hada Armed Forces Hospital, Taif, Saudi Arabia.
BMJ Open Qual. 2025 Jul 23;14(3):e002840. doi: 10.1136/bmjoq-2024-002840.
The COVID-19 pandemic has disrupted healthcare, causing challenges in managing chronic diseases like hypertension. Al-Hada Armed Forces Hospital's Pharmaceutical Care Department aims to provide safe, efficient, and effective medication refills for elderly patients pre-and post the pandemic. An improvement project was conducted at Al-Hada Armed Forces tertiary hospital to enhance medication refill processes and adherence among elderly patients with hypertension. Data on medication adherence, including refill cycle times and factors contributing to longer cycles, were collected through the Hospital Information System. The Institute for Healthcare Improvement Model for Improvement guided a study to implement a digital medication refill system. Pre-intervention and post-intervention analyses demonstrated the effectiveness of the digital system in improving medication refill processes for elderly patients with hypertension. We improved the medication refill process, reducing wait times from 40 to 5 minutes by 2022. Our system monitored medication adherence and oversupply, and it also utilized features like delivery services, online medication refills, the Tebtom system and SMS reminders. Tebtom system is an Arabic term that means 'get well soon' in English. The system includes a variety of services, such as obtaining a waiting number for upcoming appointments within 30 minutes, booking appointments, accessing medical reports, laboratory results, radiology requests, and refilling medications. The study showed a significant improvement in refill duration. Medication adherence increased from 35% to 79% with timely reminders, fewer missed doses and increased coverage of medication days. Patient medication oversupply decreased from 50% to 19%, and the system improved communication and refill convenience. A successful quality improvement method has significantly impacted our medication refill system, the effectiveness of message reminders, and patient safety through ensuring compliance with medications and reducing oversupply. During COVID-19, the digital system played a crucial role in maintaining medication access. This project highlights the positive impact of a digital refill system on efficiency and reducing medication oversupply among elderly patients with hypertension before and after the pandemic.
新冠疫情扰乱了医疗保健系统，给高血压等慢性病的管理带来了挑战。阿哈达武装部队医院的药学服务部旨在为疫情前后的老年患者提供安全、高效且有效的药物续方服务。在阿哈达武装部队三级医院开展了一项改进项目，以优化老年高血压患者的药物续方流程并提高其依从性。通过医院信息系统收集了药物依从性数据，包括续方周期时间以及导致周期延长的因素。医疗改进研究所的改进模型指导了一项实施数字药物续方系统的研究。干预前和干预后的分析表明，该数字系统在改善老年高血压患者的药物续方流程方面是有效的。到2022年，我们优化了药物续方流程，将等待时间从40分钟缩短至5分钟。我们的系统监测药物依从性和药物过量供应情况，还利用了诸如配送服务、在线药物续方、Tebtom系统和短信提醒等功能。Tebtom系统是一个阿拉伯语术语，在英语中的意思是“早日康复”。该系统包括多种服务，如在30分钟内获取即将到来预约的排队号码、预约挂号、获取医疗报告、实验室结果、放射检查申请以及药物续方。研究表明续方时长有显著改善。通过及时提醒、减少漏服剂量以及增加服药天数的覆盖，药物依从性从35%提高到了79%。患者药物过量供应从50%降至19%，并且该系统改善了沟通和续方便利性。一种成功的质量改进方法通过确保药物依从性和减少过量供应，对我们的药物续方系统、信息提醒的有效性以及患者安全产生了重大影响。在新冠疫情期间，数字系统在维持药物供应方面发挥了关键作用。该项目凸显了数字续方系统在疫情前后对老年高血压患者的效率提升以及减少药物过量供应方面的积极影响。
