Medication Reconciliation: The Foundation of Medication Safety for Patients Requiring Dialysis.
Medication Reconciliation: The Foundation of Medication Safety for Patients Requiring Dialysis.
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DOI：
10.1053/j.ajkd.2020.07.021
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发表时间：
2020-12
期刊：
影响因子：
--
通讯作者：
Manley HJ
中科院分区：
文献类型：
--
作者：
Frament J;Hall RK;Manley HJ
与药物有关的问题是发病和死亡的主要原因。需要透析的患者发生药物不良反应的风险更高，因为多种药物、多种慢性疾病的流行以及肾衰竭固有的药物药代动力学和药效学改变（但尚未充分了解）。为了尽量减少可预防的药物相关问题，医疗保健提供者需要优先考虑这一人群的药物安全。药物安全的基石是药物和解。在这里，我们提出了一个案例，强调不良后果时，药物和解是不够的，在护理过渡。我们回顾了全球范围内关于用药差异流行率的现有文献。我们还解释了有效的药物和解和在透析单位实施有效的药物和解的实际考虑。鉴于医疗保险和医疗补助服务中心终末期肾病（ESRD）质量激励计划中增加了药物核对要求，本综述还为透析单位领导提供了改进当前药物核对实践的指导。药物协调的优先顺序有可能对药物相关问题的发生率以及药物依从性、医疗费用和生活质量产生积极影响。
Medication-related problems are a leading cause of morbidity and mortality. Patients requiring dialysis are at a heightened risk of adverse drug reactions because of the prevalence of polypharmacy, multiple chronic conditions, and altered (but not well understood) medication pharmacokinetics and pharmacodynamics inherent to renal failure. To minimize preventable medication-related problems, healthcare providers need to prioritize medication safety for this population. The cornerstone of medication safety is medication reconciliation. Here, we present a case highlighting adverse outcomes when medication reconciliation is insufficient at care transitions. We review available literature on the prevalence of medication discrepancies worldwide. We also explain effective medication reconciliation and the practical considerations for implementation of effective medication reconciliation in dialysis units. In light of the addition of medication reconciliation requirements to the Centers for Medicare and Medicaid Services End-Stage Renal Disease (ESRD) Quality Incentive Program, this review also provides guidance to dialysis unit leadership for improving current medication reconciliation practices. Prioritization of medication reconciliation has the potential to positively impact rates of medication-related problems, as well as, medication adherence, healthcare costs, and quality of life.
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影响因子：
1.3
作者：
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通讯作者：
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影响因子：
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作者：
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DOI：
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发表时间：
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影响因子：
4.9
作者：
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通讯作者：
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DOI：
10.2215/cjn.01420213
发表时间：
2013-11-07
影响因子：
9.8
作者：
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通讯作者：
Mehrotra, Rajnish