Impact of team-versus ward-aligned clinical pharmacy on unintentional medication discrepancies at admission

详细信息    查看全文

• 作者：Sharon M Byrne ; Tamasine C Grimes…
• 关键词：Clinical pharmacy ; Hospital admission ; Ireland ; Medication reconciliation ; Medication safety ; Prescribing error
• 刊名：International Journal of Clinical Pharmacy
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：39
• 期：1
• 页码：148-155
• 全文大小：
• 刊物类别：Medicine
• 刊物主题：Internal Medicine; Pharmacy;
• 出版者：Springer International Publishing
• ISSN：2210-7711
• 卷排序：39

文摘

Background Medication reconciliation at admission to hospital reduces the prevalence of medication errors. Strategies are needed to ensure timely and efficient delivery of this service. Objective To investigate the effect of aligning clinical pharmacy services with consultant teams, by pharmacists attending post-admission ward rounds, in comparison to a ward-based service, on prevalence of unintentional unresolved discrepancies 48 h into admission. Setting A 243-bed public university teaching hospital in Ireland. Method A prospective, uncontrolled before-after observational study. A gold standard preadmission medication list was completed for each patient and compared with the patient’s admission medication prescription and discrepancies were noted. Unresolved discrepancies were examined at 48 h after admission to determine if they were intentional or unintentional. Main outcome measured Number of patients with one or more unintentional, unresolved discrepancy 48 h into admission. Results Data were collected for 140 patients, of whom 73.5% were over 65 years of age. There were no differences between before (ward-aligned) and after (team-aligned) groups regarding age, number of medications or comorbidities. There was a statistically significant reduction in the prevalence of unintentional, unresolved discrepancy(s) per patient (67.3 vs. 27.3%, p < 0.001) and per medication (13.7 vs. 4.1%, p < 0.001) between the groups, favouring the team-based service. The effect remained statistically significant having adjusted for patient age, number of medications and comorbidities (adjusted odds ratio 4.9, 95% confidence interval 2.3–10.6). Conclusion A consultant team-based clinical pharmacy service contributed positively to medication reconciliation at admission, reducing the prevalence of unintentional, unresolved discrepancy(s) present 48 h after admission.