Terstegen Theresa, Bittmann Janina A, Kauk Luise, Kirchner Marietta, Krug Sebastian, Gauss Annika, Chiriac Ute, Morath Benedict, Haefeli Walter E, Seidling Hanna M
Heidelberg University, Medical Faculty Heidelberg / Heidelberg University Hospital, Internal Medicine IX - Department of Clinical Pharmacology and Pharmacoepidemiology, Cooperation Unit Clinical Pharmacy, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
Heidelberg University, Medical Faculty Heidelberg / Heidelberg University Hospital, Institute of Medical Biometry, Im Neuenheimer Feld 103.3, 69120, Heidelberg, Germany.
Int J Clin Pharm. 2025 Sep 8. doi: 10.1007/s11096-025-02002-1.
Medication history taking at hospital admission is still prone to errors. Despite numerous quality improvement initiatives, new strategies to improve medication history taking are still sought and evaluated. Unfortunately, the gold standard research methodology for evaluation is resource-intensive, as it requires each patient to complete two medication history interviews. Therefore, a new study design and quality parameter were developed.
We aimed to pilot our newly developed study design and quality parameter in a study on medication history taking by telephone.
In this prospective interventional study, patients with scheduled admissions had their medication histories taken either by telephone before admission (intervention) by a pharmacist or in-person by physicians or medical interns upon admission (control). Following the newly developed design, we compared a patients' new medication histories to the respective pre-visit medication lists available in the medical records to calculate the new endpoint: the difference in the number of updates per patient. Further, we surveyed patients and staff on their satisfaction.
We enrolled 76 intervention and 75 control patients. In the intervention group, a mean of 4.93 (± 4.45, 0-18) updates were found vs. 3.40 (± 3.75, 0-21) in the control group. Accordingly, the incident rate of number of updates per patient was 1.34 times higher in the intervention group (p = 0.044). The distribution of the types of updates was similar with the most common type of update being newly initiated medicines in both groups. Medication history taking by telephone took 15.7 ± 9.8 min (mean ± SD), including preparation, interview, and documentation. Survey results showed that intervention patients felt positive about the telephone interviews. Both groups were open to other digital approaches, e.g., online platforms.
The new study design proved feasible to evaluate medication history taking by telephone with comprehensible results. The telephone approach delivered more updates compared to standard care, however, the proposed endpoint needs to be validated against the gold standard before widespread application Patient acceptance for this and other digital approaches was high in both groups.
医院入院时的用药史采集仍容易出错。尽管有众多质量改进措施，但仍在寻求和评估改善用药史采集的新策略。不幸的是，评估的金标准研究方法资源密集，因为它要求每位患者完成两次用药史访谈。因此，开发了一种新的研究设计和质量参数。
我们旨在通过一项关于电话采集用药史的研究对新开发的研究设计和质量参数进行试点。
在这项前瞻性干预研究中，计划入院的患者在入院前由药剂师通过电话采集用药史（干预组），或入院时由医生或实习医生亲自采集（对照组）。按照新开发的设计，我们将患者的新用药史与病历中各自的就诊前用药清单进行比较，以计算新的终点指标：每位患者更新数量的差异。此外，我们对患者和工作人员进行了满意度调查。
我们纳入了76名干预组患者和75名对照组患者。干预组平均发现4.93（±4.45，0 - 18）次更新，而对照组为3.40（±3.75，0 - 21）次。相应地，干预组每位患者更新数量的发生率比对照组高1.34倍（p = 0.044）。更新类型的分布相似，两组中最常见的更新类型都是新启用的药物。电话采集用药史耗时15.7 ± 9.8分钟（平均值±标准差），包括准备、访谈和记录。调查结果显示，干预组患者对电话访谈持积极态度。两组都对其他数字方法持开放态度，例如在线平台。
新的研究设计被证明可用于评估电话采集用药史，结果易于理解。与标准护理相比，电话方式提供了更多更新信息，然而，在广泛应用之前，所提出 的终点指标需要与金标准进行验证。两组患者对这种及其他数字方法的接受度都很高。
