Impact of an Outpatient Pharmacist Intervention on Medication Discrepancies and Health Care Resource Utilization in Posthospitalization Care Transitions
Impact of an Outpatient Pharmacist Intervention on Medication Discrepancies and Health Care Resource Utilization in Posthospitalization Care Transitions
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DOI：
10.1177/2150131913502489
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发表时间：
2014-01-01
影响因子：
3.6
通讯作者：
Lin, Feng-Chang
中科院分区：
文献类型：
--
作者：
Hawes, Emily M.;Maxwell, Whitney D.;Lin, Feng-Chang
目的：与出院相关的用药错误导致再次住院和急诊科（艾德）就诊，但在全国范围内还没有实施系统的方法来减少这些用药错误。在出院后过渡期的治疗过程中，药剂师的参与可能是预防和纠正用药差异，减少昂贵的再住院和艾德就诊的重要策略。研究方法：这项前瞻性、随机、开放标签、初步研究评价了出院后药房门诊访视（侧重于药物核对和患者教育）对再住院和艾德访视发生率以及药物差异解决的影响。结果：在纳入研究的61例受试者中，33例（54%）在出院时发现用药差异。在随机分配到药剂师干预组的受试者中，50%的药物差异得到解决，而常规护理组为9.5%（P = 0.015）。随机分配到干预组的患者与常规治疗组相比，30天再住院和艾德访视的主要复合结局发生率显著降低（0% vs 40.5%，P
Purpose: Medication errors related to hospital discharge result in rehospitalization and emergency department (ED) visits, yet no systematic approach has been implemented nationally to decrease these medication errors. Pharmacist involvement during postdischarge transitions of care may be an important strategy to prevent and correct medication discrepancies and reduce costly rehospitalization and ED visits. Methods: This prospective, randomized, open-label, pilot study evaluated the effect of a pharmacy clinic visit focused on medication reconciliation and patient education after hospital discharge on the incidence of rehospitalization and ED visits and the resolution of medication discrepancies. Results: Of the 61 subjects included in the study, 33 (54%) had medication discrepancies identified at discharge. Fifty percent of medication discrepancies were resolved in subjects randomized to the pharmacist intervention arm compared with 9.5% in the usual care arm (P =.015). Patients randomized to the intervention arm had significantly lower rates of the primary composite outcome of 30-day rehospitalization and ED visits compared with the usual care arm (0% vs 40.5%, P