Enhancing Medication History Accuracy in a Tertiary Hospital: Pharmacist-Led Counseling With Nationwide Medication History Sharing Program Versus Conventional Methods

IF 2.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Clinical Practice Pub Date : 2024-11-29 DOI:10.1155/ijcp/4554730

Hyunwoo Chae, Subin Yoon, Soyoung Park, A Jeong Kim, Kyu-Nam Heo, Yookyung Kim, Jeong Yeon Seok, Sung Hwan Kim, Taeyoung Yun, Ji Hyeon Park, Yoon Sook Cho, Young Tae Kim, Hyun Joo Lee, Ju-Yeun Lee

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Abstract

Aims: Medication discrepancies during transitions of care pose substantial risks, particularly in older patients receiving complex medication regimens. Obtaining the best possible medication history (BPMH) is crucial to minimize this risk. This study aimed to evaluate the effectiveness of a pharmacist-led BPMH using various information sources including a nationwide medication history sharing program compared to conventional interviews in a tertiary hospital setting. In addition, we identified factors contributing to medication inaccuracies.

Methods: A single-center prospective study involving older patients scheduled for thoracic surgery at a tertiary hospital was conducted. Medication histories obtained through conventional interviews during the initial assessment on admission were compared with those obtained through BPMH by pharmacist-led interviews. Logistic regression analysis was used to identify factors associated with medication inaccuracies.

Results: This study included 216 patients, a significant proportion of whom were experiencing polypharmacy. The pharmacist-led BPMH approach demonstrated superior accuracy in documenting medication histories, with conventional methods showing inaccuracies in over 70% of the cases. Factors that significantly increased the likelihood of inaccuracies included the number of medications and number of prescribers. Nonoral and as-needed medications are particularly prone to inaccuracies.

Conclusions: Pharmacist-led BPMH significantly improved medication history accuracy compared to conventional methods, which had inaccuracies in over 70%. It is important to be careful when obtaining BPMH for older adults, particularly those with complex medication regimens, nonoral medications, or PRN medications, to enhance patient safety and reduce medication-related risks.

Trial Registration: Clinical Trial Registry identifier: KCT-006813.

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提高三级医院用药史准确性：药剂师主导的咨询与全国用药史共享计划对比传统方法

目的：在护理过渡期间的药物差异会造成重大风险，特别是在接受复杂药物治疗方案的老年患者中。获得最佳的用药史（BPMH）对于最小化这种风险至关重要。本研究旨在评估药剂师主导的BPMH的有效性，使用各种信息来源，包括全国用药历史共享计划，与三级医院设置的传统访谈相比。此外，我们还确定了导致用药不准确的因素。方法：采用单中心前瞻性研究，纳入在某三级医院行胸外科手术的老年患者。将入院初期评估时通过常规访谈获得的用药史与通过药师主导的BPMH访谈获得的用药史进行比较。采用Logistic回归分析确定与用药不准确相关的因素。结果：本研究共纳入216例患者，其中有相当比例的患者正在进行多药治疗。药剂师主导的BPMH方法在记录用药史方面表现出卓越的准确性，而传统方法在70%以上的病例中显示不准确。显著增加不准确可能性的因素包括药物数量和开处方者数量。非口服和按需用药尤其容易出现不准确。结论：与传统方法相比，药师主导的BPMH显著提高了用药史准确性，其不准确性超过70%。对于老年人，特别是那些使用复杂药物方案、非口服药物或PRN药物的老年人，在获得BPMH时要非常小心，以加强患者安全并减少药物相关风险。试验注册：临床试验注册标识：KCT-006813。

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来源期刊

International Journal of Clinical Practice 医学-医学：内科

CiteScore

5.30

自引率

0.00%

发文量

274

审稿时长

3-8 weeks

期刊介绍： IJCP is a general medical journal. IJCP gives special priority to work that has international appeal. IJCP publishes: Editorials. IJCP Editorials are commissioned. [Peer reviewed at the editor''s discretion] Perspectives. Most IJCP Perspectives are commissioned. Example. [Peer reviewed at the editor''s discretion] Study design and interpretation. Example. [Always peer reviewed] Original data from clinical investigations. In particular: Primary research papers from RCTs, observational studies, epidemiological studies; pre-specified sub-analyses; pooled analyses. [Always peer reviewed] Meta-analyses. [Always peer reviewed] Systematic reviews. From October 2009, special priority will be given to systematic reviews. [Always peer reviewed] Non-systematic/narrative reviews. From October 2009, reviews that are not systematic will be considered only if they include a discrete Methods section that must explicitly describe the authors'' approach. Special priority will, however, be given to systematic reviews. [Always peer reviewed] ''How to…'' papers. Example. [Always peer reviewed] Consensus statements. [Always peer reviewed] Short reports. [Always peer reviewed] Letters. [Peer reviewed at the editor''s discretion] International scope IJCP publishes work from investigators globally. Around 30% of IJCP articles list an author from the UK. Around 30% of IJCP articles list an author from the USA or Canada. Around 45% of IJCP articles list an author from a European country that is not the UK. Around 15% of articles published in IJCP list an author from a country in the Asia-Pacific region.