Xiaoyan Chen, Lin Liu, Jie Zhang, Linghua Zheng, Xiaona Chen, Mingxia Zhang
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引用次数: 0
Abstract
Purpose: Patients' own medications (POMs) may pose safety risks when their use is not integrated into hospital medication-management processes. This study evaluated a multidisciplinary intervention for POM management in hospitalized older adults.
Patients and methods: This single-center before-and-after intervention study was conducted from March 2024 to February 2025. The intervention comprised five coordinated components: physician-led assessment, authorization, order entry, guidance, and monitoring; pharmacist-led verification, order review, and record maintenance; nurse-led verification, supervision, and education using color-coded labels (green, approved for use; red, not to be used; yellow, awaiting confirmation); IT-led integration of POM information into the electronic medication administration record; and procurement-led upgrades to storage equipment. The primary outcome was the incidence rate of POM-related medication errors per 1000 patient-days. Secondary outcomes were correct POM documentation within 24 hours of admission and correct POM storage at the pre-discharge assessment.
Results: The study included 162 patients, with 81 in each period. Before the intervention, 174 POM-related medication errors occurred over 1628 patient-days (106.9 per 1000 patient-days), compared with 29 errors over 1581 patient-days after the intervention (18.3 per 1000 patient-days). The incidence rate ratio was 0.172 (95% CI, 0.116-0.254; P<0.001), representing an 82.8% reduction. Correct POM documentation within 24 hours increased from 53.1% (43/81) to 92.6% (75/81; χ2=31.951, P<0.001; OR=11.047, 95% CI, 4.319-28.253; RR=1.744, 95% CI, 1.408-2.160). Correct POM storage at the pre-discharge assessment increased from 32.1% (26/81) to 84.0% (68/81; χ2=44.707, P<0.001).
Conclusion: The intervention was associated with improvements in all three measured POM outcomes at this center. Multicenter studies with longer follow-up are needed to assess generalizability and sustainability.
期刊介绍：
Patient Preference and Adherence is an international, peer reviewed, open access journal that focuses on the growing importance of patient preference and adherence throughout the therapeutic continuum. The journal is characterized by the rapid reporting of reviews, original research, modeling and clinical studies across all therapeutic areas. Patient satisfaction, acceptability, quality of life, compliance, persistence and their role in developing new therapeutic modalities and compounds to optimize clinical outcomes for existing disease states are major areas of interest for the journal.
As of 1st April 2019, Patient Preference and Adherence will no longer consider meta-analyses for publication.
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