医院-家庭过渡期老年多重用药患者服药偏差现状调查

Medication discrepancies in elderly patients with polypharmacy during the hospital-to-home transitional period

目的分析医院-家庭过渡期老年多重用药患者服药偏差现状,并探讨服药偏差与出院指导质量、出院准备度的相关性。方法以265名老年多重用药患者为研究对象,在出院当天采用一般资料调查表、出院指导质量量表及出院准备度量表进行调查;出院后1周,采用服药偏差评估工具进行电话随访。结果出院后1周内服药偏差发生率为61.89%,主要偏差类型为服药种类减少(40.28%),主要偏差原因为患者源性(53.61%)。服药偏差与出院指导质量、出院准备度呈负相关(均P<0.05)。回归分析结果显示,年龄、居住情况、出院带药数量、住院天数、疾病数量及出院指导质量是服药偏差的影响因素(均P<0.05)。结论医院-家庭过渡期老年多重用药患者服药偏差发生率较高,其影响因素较多。应加强对老年多重用药患者的服药偏差管理,提高出院指导质量,以确保患者用药安全。

Objective To analyze the current situation of medication discrepancy in elderly patients taking multiple drugs during the hospital-to-home transitional period,and explore the correlation between medication discrepancy and discharge guidance and readiness for hospital discharge.Methods A total of 265 elderly patients taking multiple drugs were selected and investigated using a general information questionnaire,the Quality of Discharge Teaching Scale(QDTS),Readiness for Hospital Discharge Scale(RHDS)on the day of discharge.One week after discharge,the medication discrepancy tool(MDT)was used for telephone follow-up of patients.Results The incidence of medication discrepancy within 1 week after discharge was 61.89%.The main type of and reason for discrepancy was the decrease in the types of medication(40.28%),and patient-originated(53.61%)respectively.Medication discrepancy was negatively correlated with the quality of discharge teaching and readiness for discharge(both P<0.05).The results of regression analysis showed that age,residence condition,medications prescribed at discharg,length of stay,number of diseases and quality of discharge teaching were the influencing factors of medication discrepancy(all P<0.05).Conclusion The incidence of medication discrepancy is high among elderly patients with multiple drugs in hospital-to-home transitional period for many reasons.Therefore,medical staff should streng the nthemanagement for medication discrepancy,and improve quality of health guidance at discharge,so as to ensure medication safety.