Hospital-based medication reconciliation practices: a systematic review.
Hospital-based medication reconciliation practices: a systematic review.
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DOI：
10.1001/archinternmed.2012.2246
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发表时间：
2012-07-23
影响因子：
--
通讯作者：
Schnipper, Jeffrey L.
中科院分区：
文献类型：
--
作者：
Mueller, Stephanie K.;Sponsler, Kelly Cunningham;Kripalani, Sunil;Schnipper, Jeffrey L.
治疗过渡期间的用药差异很常见，并导致患者伤害。药物协调是降低这种风险的一种策略。总结医院环境中药物协调干预的现有证据，并确定最有效的做法。Medline（1966年至2012年2月）和手动检索文献参考书目。26篇对照研究提取了研究设计、设置、参与者、纳入/排除标准、干预成分、时间、对照组、结局和结果的数据。研究按药物协调干预的类型进行分组：药剂师相关、信息技术（IT）或其他，并使用美国咨询服务工作组标准进行质量评级。26项研究中有15项报告了药剂师相关干预措施，6项评估了IT干预措施，5项研究了其他干预措施。6项研究被归类为高质量。所有研究的对照组均为常规护理，没有直接比较不同类型的干预措施。研究一致表明药物差异（17/17项研究）、潜在药物不良事件（5/6项研究）和药物不良事件（2/3项研究）减少，但出院后医疗保健利用率的减少不一致（2/8项研究改善）。成功的干预措施的关键方面包括密集的药房工作人员的参与，并有针对性的干预，以“高风险”的患者群体。有一个严格设计的研究比较不同的住院药物和解的做法和他们对临床结果的影响很少。现有证据支持药物协调干预措施，这些干预措施大量利用药房工作人员，并侧重于不良事件高风险患者。需要更高质量的研究来确定住院药物协调的最有效方法。
Medication discrepancies at care transitions are common and lead to patient harm. Medication reconciliation is a strategy to reduce this risk. To summarize available evidence on medication reconciliation interventions in the hospital setting and identify the most effective practices. Medline (1966 through February 2012) and hand search of article bibliographies. 26 controlled studies. Data were extracted on study design, setting, participants, inclusion/exclusion criteria, intervention components, timing, comparison group, outcomes, and results. Studies were grouped by type of medication reconciliation intervention: pharmacist-related, information technology (IT), or other, and assigned quality ratings utilizing U.S. Preventative Services Task Force criteria. 15 of 26 studies reported on pharmacist-related interventions, 6 evaluated IT interventions, and 5 studied other interventions. 6 studies were classified as good quality. The comparison group for all studies was usual care, with no direct comparisons of different types of interventions. Studies consistently demonstrated a reduction in medication discrepancies (17/17 studies), potential adverse drug events (5/6 studies), and adverse drug events (2/3 studies), but showed inconsistent reduction in post-discharge healthcare utilization (improvement in 2/8 studies). Key aspects of successful interventions included intensive pharmacy staff involvement and targeting the intervention to a ‘high-risk’ patient population. There is a paucity of rigorously designed studies comparing different inpatient medication reconciliation practices and their effects on clinical outcomes. Available evidence supports medication reconciliation interventions that heavily utilize pharmacy staff and focus on patients at high-risk for adverse events. Higher quality studies are needed to determine the most effective approaches to inpatient medication reconciliation.
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影响因子：
5.7
作者：
Forster, AJ;Murff, HJ;Bates, DW
通讯作者：
Bates, DW
影响因子：
--
作者：
Midlov, Patrik;Deierborg, Eva;Eriksson, Tommy
通讯作者：
Eriksson, Tommy
影响因子：
2.7
作者：
Murphy, Eileen M.;Oxencis, Carolyn J.;Zimmerman, Jill M.
通讯作者：
Zimmerman, Jill M.
影响因子：
--
作者：
Eggink, Rixt Nynke;Lenderink, Albert W.;van den Bemt, Patricia M. L. A.
通讯作者：
van den Bemt, Patricia M. L. A.
影响因子：
2.7
作者：
Michels, RD;Meisel, SB
通讯作者：
Meisel, SB