Clinical outcomes from the use of Medication Report when elderly patients are discharged from hospital
Clinical outcomes from the use of Medication Report when elderly patients are discharged from hospital
复制标题
DOI：
10.1007/s11096-008-9236-1
复制
发表时间：
2008-12-01
影响因子：
--
通讯作者：
Eriksson, Tommy
中科院分区：
文献类型：
--
作者：
Midlov, Patrik;Deierborg, Eva;Eriksson, Tommy
目的探讨用药报告单是否也能减少因用药错误而导致临床结局的患者数量。方法对瑞典隆德大学医院三个科室的转移到初级保健的患者进行前瞻性干预研究和回顾性对照。干预组患者在出院时收到药物报告，对照组患者年龄相同，一年前从同一病房出院时未收到药物报告。对于至少有一次用药错误的患者，确定了出院后3个月内与医院或初级保健的所有接触。对于每次联系，都评估这是否是由用药错误引起的。我们还比较了被评估为高或中度临床风险的用药错误与无临床风险的用药错误。主要结果测量出院后三个月内在医院或初级保健中需要医疗护理。医疗护理是指研究人群再次入院以及接受初级和门诊二级卫生保健。结果用药报告单的使用减少了因用药差错而需要就医的情况。在有用药报告的患者中，11/248例（4.4%）因用药错误需要医疗护理，而16/179例（8.9%）无用药报告（p = 0.049）。用药报告的使用显著降低了用药错误导致的任何后果的风险，p = 0.0052。这些后果包括由于用药错误以及医生在医院或初级保健中进行的行政程序（纠正）而可能和可能的护理。结论用药报告是减少老年患者出院后不良临床后果的有效工具。
Objective The objective of this study was to investigate whether a Medication Report also can reduce the number of patients with clinical outcomes due to medication errors. Method A prospective intervention study with retrospective controls on patients at three departments at Lund University Hospital, Sweden that where transferred to primary care. The intervention group, where patients received a Medication Report at discharge, was compared with a control group with patients of the same age, who were not given a Medication Report when discharged from the same ward one year earlier. For patients with at least one medication error all contacts with hospital or primary care within 3 months after discharge were identified. For each contact it was evaluated whether this was caused by the medication error. We also compared medication errors that have been evaluated as high or moderate clinical risk with medication errors without clinical risk. Main outcome measures Need for medical care in hospital or primary care within three months after discharge from hospital. Medical care is readmission to hospital as well as visits of study population to primary and out-patient secondary health care. Results The use of Medication Report reduced the need for medical care due to medication errors. Of the patients with Medication Report 11 out of 248 (4.4%) needed medical care because of medication errors compared with 16 out of 179 (8.9%) of patients without Medication Report (p = 0.049). The use of a Medication Report significantly reduced the risk of any consequences due to medication errors, p = 0.0052. These consequences included probable and possible care due to medication error as well as administrative procedures (corrections) made by physicians in hospital or primary care. Conclusions The Medication Report seems to be an effective tool to decrease adverse clinical consequences when elderly patients are discharged from hospital care.