Williford S L, Johnson D F
Womack Army Medical Center, Fort Bragg, NC 28307, USA.
Mil Med. 1995 Nov;160(11):561-4.
The impact of discharge counseling was measured in a veteran patient population in a large tertiary-care government medical center. Upon discharge, seventy patients were randomly assigned to one of two groups: one group received verbal medication counseling from a pharmacist, the other group did not. Medication knowledge and compliance were assessed by interviewing each patient approximately 6 weeks after discharge. Sixty patients (31 counseled, 29 uncounseled) completed the study. Forty-five patients were from our rehabilitation division (housing psychiatric, intermediate, and long-term care patients), and 15 patients were from our acute-care division. Overall, counseled patients were no more knowledgeable or compliant than uncounseled patients. However, among those patients discharged from our acute-care division, counseled patients were more knowledgeable and compliant than uncounseled patients. In all patients, medication knowledge and compliance decreased as their number of medications increased. Our discharge counseling program had little impact when examining all study patients. But in acute-care patients, discharge counseling did increase both medication knowledge and compliance. Our study also showed that, in both counseled and uncounseled patients, medication knowledge and compliance decreased as the number of discharge medications increased, and additional pharmacist counseling would likely prove beneficial to those patients discharged on multiple medications.
在一家大型三级政府医疗中心的退伍军人患者群体中,对出院咨询的影响进行了评估。出院时,70名患者被随机分为两组:一组接受药剂师的口头用药咨询,另一组不接受。出院后约6周,通过对每位患者进行访谈来评估用药知识和依从性。60名患者(31名接受咨询,29名未接受咨询)完成了研究。45名患者来自我们的康复科(收治精神科、中级和长期护理患者),15名患者来自我们的急症科。总体而言,接受咨询的患者在知识掌握程度或依从性方面并不比未接受咨询的患者更好。然而,在那些从我们急症科出院的患者中,接受咨询的患者比未接受咨询的患者知识掌握程度更高且依从性更好。在所有患者中,用药知识和依从性随着用药数量的增加而降低。在检查所有研究患者时,我们的出院咨询计划影响甚微。但在急症患者中,出院咨询确实提高了用药知识和依从性。我们的研究还表明,在接受咨询和未接受咨询的患者中,用药知识和依从性都随着出院用药数量的增加而降低,额外的药剂师咨询可能对那些出院时服用多种药物的患者有益。