评估医院病房老年患者入院和出院时药物核对中发现的差异

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Barbara Falaschi Romeiro, Alan Maicon de Oliveira, João Paulo Vilela Rodrigues, Marília Silveira de Almeida Campos, Fabiana Rossi Varallo, Leonardo Régis Leira Pereira
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引用次数: 0

摘要

老龄化人口通常身患多种疾病,且多重用药复杂,因此在医疗保健过渡期间需要全面的护理。这些转变导致处方增加,加剧了老年人的多药并发症和虚弱。药物协调作为一种预防性策略,可通过系统分析来优化用药清单,尤其有益于饱受多种药物困扰的老年患者。这种做法在加强护理过渡期间的患者安全方面具有很大的潜力。因此,本研究旨在评估巴西某病房中老年人在入院、出院或转院时的用药核对过程中发现的差异。这是一项单一队列研究,研究对象为巴西一家老年护理病房的住院患者,监测时间为 2021 年 9 月至 2022 年 4 月。在病房住院的老年人表现出多病和多药的临床特征,研究人员对他们进行了观察,以确定作为药物护理服务一部分的药物协调实践中存在的差异。在老年人入院、出院或转入其他医疗单位时,都要进行药物协调。在研究期间,对病房中的 60 名老年人进行了监测。超过 70% 的患者在家中使用多种药物,超过 90% 的患者患有多种疾病。平均每名患者发现 8.6 项差异(± 4.7)。在入住老年人护理病房时,共发现并评估了 501 项差异,在出院或转至其他病房时,差异减少至 200 项。在评估的处方和正在进行的药物治疗中,共发现了 48 处用药错误。事实证明,使用多种药物是导致在药物核对中发现差异增多的一个因素(p < 0.001)。分析用药核对差异可发现处方中有意和无意的方面,用药量,尤其是多种药物的用药量与潜在的伤害有关。事实证明,持续监测至关重要,可显著提高老年人护理病房的患者安全。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of Discrepancies Identified in Medication Reconciliation at Admission and Discharge of Older Patients in a Hospital Ward

The aging population, often burdened with multimorbidity and polypharmacy complexities, requires comprehensive care during healthcare transitions. These transitions contribute to increased prescriptions, exacerbating polypharmacy and frailty in older individuals. Medication reconciliation, a preventive strategy, optimizes medication lists through systematic analysis, particularly benefiting older patients grappling with polypharmacy. This practice holds substantial potential in enhancing patient safety during care transitions. Therefore, the aim of this study is to evaluate the discrepancies detected during the practice of medication reconciliation at the admission, discharge, or transfer of older individuals in a ward in Brazil. This is a single-cohort study of patients admitted to an older adult care ward in Brazil, monitored from September 2021 to April 2022. Older individuals hospitalized in the ward, exhibiting the characteristic clinical profile of multimorbidity and polypharmacy, were observed to identify discrepancies in the practice of medication reconciliation conducted as part of pharmaceutical care services. Medication reconciliation was carried out upon admission, discharge from the ward for older adult care, or transfer to other healthcare units. Sixty older individuals were monitored during the study period in the ward. The use of polypharmacy at home was evident in more than 70% of patients, and multimorbidity was present in over 90% of patients. On average, 8.6 discrepancies were identified per patient (± 4.7). Upon admission to the older adult care ward, 501 discrepancies were identified and assessed, decreasing to 200 at the time of hospital discharge or transfer to other units. In total, 48 medication errors were identified in the evaluated prescriptions and ongoing pharmacotherapy. The use of polypharmacy proved to be a contributing factor that increased the identification of discrepancies in medication reconciliation (p < 0.001). Analyzing medication reconciliation discrepancies uncovers intentional and unintentional aspects in prescriptions, with medication quantity, especially in polypharmacy, linked to potential harm. Continuous monitoring proved crucial, significantly enhancing patient safety in the older adult care ward.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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