全院范围内的药物和解计划:错误识别,成本效益,并在入院时检测高风险个体。

IF 2.1 Q3 PHARMACOLOGY & PHARMACY Integrated Pharmacy Research and Practice Pub Date : 2020-10-13 eCollection Date: 2020-01-01 DOI:10.2147/IPRP.S269857
Dustin J Uhlenhopp, Oscar Aguilar, Dong Dai, Arka Ghosh, Michael Shaw, Chandan Mitra
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引用次数: 7

摘要

背景:入院时的药物调解(MR)有可能减少患者的负面结果。这项前瞻性观察性研究的目的是:1)衡量全院范围内的磁共振项目对入院时家庭用药错误识别的影响;2)证明该项目的成本效益;3)确定使个体患者用药不一致风险更高的风险因素。方法:技术人员获取住院自行用药的成年患者的用药史。记录用药错误的频率和类型。成本避免估计是根据预期的药物不良事件发生率确定的。采用Logistic回归分析检验用药错误与患者特征之间的关系。当p值小于0.05时,认为结果显著。结果:纳入817例患者。技术人员平均记录每位患者6.1个用药差异(SD±0.4),耗时28.5分钟(SD±1.2分钟)完成用药史。遗漏、委托和剂量/频率错误分别发生在82%、59%和50%的用药史中。我们估计使用该方案可为每位患者节省210.33美元的费用。女性性别、年龄和高警戒/高风险药物使用与药物差异发生的可能性增加有关。结论:本研究验证了药学技术人员识别错误的能力,证明了经济成本效益,及时提供了获得BPMH的新数据,并进一步确定了导致用药差异发生的因素。潜在有害的用药差异在入院时经常被发现。通过进一步的研究,有可能在入院时识别出家庭用药差异风险最高的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Hospital-Wide Medication Reconciliation Program: Error Identification, Cost-Effectiveness, and Detecting High-Risk Individuals on Admission.

Background: Medication reconciliation (MR) on admission has potential to reduce negative patient outcomes. The objectives of this prospective observational study were to 1) measure the impact a hospital-wide MR program has on home medication error identification at hospital admission, 2) demonstrate cost-effectiveness of this program, and 3) identify risk factors placing individual patients at higher risk for medication discrepancies.

Methods: Technicians obtained medication histories on adult patients admitted to the hospital that managed their own medications. Frequency and type of medication errors were recorded. Cost avoidance estimations were determined based on expected adverse drug event rates. Logistic regression analysis was used to test for associations between medication errors and patient characteristics. Results were considered significant when p-value was less than 0.05.

Results: The study included 817 patients. Technicians recorded a mean of 6.1 medication discrepancies per patient (SD ± 0.4) and took 28.5 minutes (SD ± 1.2 minutes) to complete a medication history. Omission, commission, and dosing/frequency errors occurred in 82%, 59%, and 50% of medication histories, respectively. We estimated cost avoidance of $210.33 per patient with this program. Female gender, age, and high alert/risk medication use were linked to an increase in the likelihood of occurrence of a medication discrepancy.

Conclusion: This study validated the ability of a pharmacy technician to identify errors, demonstrated economic cost-effectiveness, provided new data on time to obtain a BPMH, and further identified factors that contribute to the occurrence of medication discrepancies. Potentially harmful medication discrepancies were identified frequently on admission. With further research, it may be possible to identify those at highest risk for home medication discrepancies upon admission.

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自引率
3.40%
发文量
29
审稿时长
16 weeks
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