Documentation of the Patient Characteristics Morbid Obesity and Bariatric Surgery in the Hospital Information System and the Influence on the Number of Medication-Related Problems.

IF 2.3 4区 医学 Q3 PHARMACOLOGY & PHARMACY
Annals of Pharmacotherapy Pub Date : 2024-10-01 Epub Date: 2024-01-24 DOI:10.1177/10600280231226243
Jurjen S Kingma, Iris A M Brenkman, Marcel P H van den Broek, Patricia M L A van den Bemt, Karin Janssen, Catherijne A J Knibbe, Desirée M T Burgers
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引用次数: 0

Abstract

Background: As a result of pharmacokinetic changes, individuals with morbid obesity and/or with bariatric surgery may require dose adjustments, additional monitoring or medication should be avoided. Clinical decision support (CDS) may provide automated alerts enabling correct prescribing but requires documentation of these patient characteristics in the Hospital Information System (HIS) to prevent medication-related problems (MRPs).

Objective: The primary objective is to determine the proportion of patients with documentation of the patient characteristics morbid obesity and bariatric surgery in the HIS. The secondary objective is to compare the proportion of patients with an MRP in the group with versus without documentation. Also, the type and severity of MRPs and the medication involved are determined.

Methods: A prospective cohort study was performed. Patients admitted to the hospital were identified as morbidly obese and/or with bariatric surgery. In the identified patients, the proportion of patients with documentation of the patient characteristics in the HIS was evaluated as primary outcome. Subsequently, patient records were reviewed for MRPs, which were categorized and associated medication was registered. For the primary objective, descriptive statistics was used. For the secondary outcome, the Fisher's exact test was used.

Results: In 43 (21.4%, 95% confidence interval [CI]: 15.7%-27.1%) of 201 included patient (113 morbid obesity, 70 bariatric surgery and 18 both), the patient characteristics were documented. An MRP occurred in 2.3% versus 13.9% (P = 0.032) of patients with and without documentation, respectively. The most common MRP was underdosing in morbid obesity, while in patients with bariatric surgery it was prescription of contra-indicated medication.

Conclusion and relevance: The proportion of patients with documentation of the patient characteristics bariatric surgery and/or morbid obesity in the HIS is low, which appears to be associated with more MRPs. To improve medication safety, it is important to document these patient characteristics.

医院信息系统中记录的患者特征(肥胖症和减肥手术)及其对用药相关问题数量的影响。
背景:由于药代动力学的变化,病态肥胖和/或接受过减肥手术的患者可能需要调整剂量、进行额外监测或避免用药。临床决策支持(CDS)可提供自动提示,以便正确开药,但需要在医院信息系统(HIS)中记录这些患者的特征,以防止出现药物相关问题(MRP):主要目的是确定在 HIS 中记录了病态肥胖和减肥手术患者特征的患者比例。次要目标是比较有记录和无记录组中出现 MRP 的患者比例。此外,还要确定 MRP 的类型和严重程度以及涉及的药物:进行了一项前瞻性队列研究。入院患者被确认为病态肥胖和/或接受过减肥手术。在确定的患者中,HIS中记录患者特征的患者比例作为主要结果进行评估。随后,对患者病历中的 MRP 进行审查,并对 MRP 进行分类和登记相关药物。对于首要目标,采用了描述性统计方法。次要结果采用费雪精确检验:在纳入的 201 例患者中,有 43 例(21.4%,95% 置信区间[CI]:15.7%-27.1%)(病态肥胖 113 例,减肥手术 70 例,两者皆有 18 例)记录了患者特征。有记录和无记录的患者中,发生 MRP 的比例分别为 2.3% 和 13.9%(P = 0.032)。最常见的 MRP 是病态肥胖症患者用药不足,而减肥手术患者则是开具了禁忌药物:在 HIS 中记录有减肥手术和/或病态肥胖特征的患者比例较低,这似乎与 MRP 的增加有关。为提高用药安全,记录这些患者特征非常重要。
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来源期刊
CiteScore
5.70
自引率
0.00%
发文量
166
审稿时长
3-8 weeks
期刊介绍: Annals of Pharmacotherapy (AOP) is a peer-reviewed journal that advances pharmacotherapy throughout the world by publishing high-quality research and review articles to achieve the most desired health outcomes.The articles provide cutting-edge information about the most efficient, safe and cost-effective pharmacotherapy for the treatment and prevention of various illnesses. This journal is a member of the Committee on Publication Ethics (COPE). Average time from submission to first decision: 14 days
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