PDF(Pubmed)
Abstract：
BACKGROUND: Older adult patients are particularly vulnerable to medication-related issues during the discharge process. To enhance medication discharge education and patient experience, a written medication reminder, incorporating crucial medication side effects and warning signs, was implemented in medicine wards. This study aimed to examine the influence of this reminder on patient experience and medication-taking behaviors among older adults in public healthcare settings.
METHODS: Two separate rounds of cross-sectional surveys were conducted before and after the program implementation among different discharged patients in each round. The study enrolled older adult patients aged ≥ 65 or their caregivers discharged from the medical wards of four pilot public hospitals in Hong Kong. A structured questionnaire was administered via telephone within 14 days of the patient\'s discharge. The survey assessed patients\' experience with the provided medication information during discharge, including the clarity, adequacy, and usefulness of the information, as well as their overall experience with inpatient services. The self-reported medication-taken behaviors, including adherence and side-effect encounters, were also measured.
RESULTS: A total of 1,265 responses were collected before the implementation of the medication reminder, and 1,426 responses were obtained after the implementation. Pre/post-implementation survey comparison showed significant improvement in patient experience regarding the clarity of the provided medication information (7.93 ± 1.84 vs. 8.18 ± 1.69, P = 0.002), adequacy (7.92 ± 1.93 vs. 8.15 ± 1.76, P = 0.014), and usefulness (8.06 ± 1.80 vs. 8.26 ± 1.70, P = 0.017), significantly positive experience on the overall discharge information (β coefficient, 0.43 [95%CI, 0.30 to 0.56]) and inpatient service (β coefficient, 0.47 [95%CI, 0.32 to 0.61]). In addition, the side effects encounters were significantly lower in the post-implementation survey group (11.6% vs. 9.0%, P = 0.04) and no statistical difference was found in self-reported medication adherence between the two groups.
CONCLUSIONS: The provision of written medication reminders on key medication risks effectively improved older adult patients\' experience and reduced side effects without any unintended negative consequences. The findings can serve as a reference for similar settings seeking to enhance post-discharge care among older adult patients. Future studies could investigate the influence in other specialties and age groups and include clinical outcomes to test the program\'s effectiveness.
METHODS: Two separate rounds of cross-sectional surveys were conducted before and after the program implementation among different discharged patients in each round. The study enrolled older adult patients aged ≥ 65 or their caregivers discharged from the medical wards of four pilot public hospitals in Hong Kong. A structured questionnaire was administered via telephone within 14 days of the patient\'s discharge. The survey assessed patients\' experience with the provided medication information during discharge, including the clarity, adequacy, and usefulness of the information, as well as their overall experience with inpatient services. The self-reported medication-taken behaviors, including adherence and side-effect encounters, were also measured.
RESULTS: A total of 1,265 responses were collected before the implementation of the medication reminder, and 1,426 responses were obtained after the implementation. Pre/post-implementation survey comparison showed significant improvement in patient experience regarding the clarity of the provided medication information (7.93 ± 1.84 vs. 8.18 ± 1.69, P = 0.002), adequacy (7.92 ± 1.93 vs. 8.15 ± 1.76, P = 0.014), and usefulness (8.06 ± 1.80 vs. 8.26 ± 1.70, P = 0.017), significantly positive experience on the overall discharge information (β coefficient, 0.43 [95%CI, 0.30 to 0.56]) and inpatient service (β coefficient, 0.47 [95%CI, 0.32 to 0.61]). In addition, the side effects encounters were significantly lower in the post-implementation survey group (11.6% vs. 9.0%, P = 0.04) and no statistical difference was found in self-reported medication adherence between the two groups.
CONCLUSIONS: The provision of written medication reminders on key medication risks effectively improved older adult patients\' experience and reduced side effects without any unintended negative consequences. The findings can serve as a reference for similar settings seeking to enhance post-discharge care among older adult patients. Future studies could investigate the influence in other specialties and age groups and include clinical outcomes to test the program\'s effectiveness.
摘要：
背景：老年成年患者在出院过程中特别容易受到药物相关问题的影响。加强出院教育及病人体验,书面用药提醒,结合关键的药物副作用和警告信号，在医学病房实施。这项研究旨在研究这种提醒对公共医疗机构中老年人的患者体验和服药行为的影响。
方法：在计划实施前后，对每一轮不同的出院患者进行了两轮独立的横断面调查。这项研究纳入了年龄≥65岁的老年患者或他们的照顾者，他们从香港四家试点公立医院的病房出院。患者出院后14天内通过电话进行结构化问卷调查。该调查评估了患者在出院期间对所提供药物信息的体验，包括清晰度，充分性，以及信息的有用性，以及他们在住院服务方面的整体经验。自我报告的服药行为，包括依从性和副作用，也被测量了。
结果：在实施用药提醒前，共收集到1,265份应答，实施后获得1，426份答复。实施前/后调查比较显示，在提供的药物信息的清晰度方面，患者体验有了显著改善(7.93±1.84vs.8.18±1.69,P=0.002),充分性（7.92±1.93vs.8.15±1.76,P=0.014),和有用性(8.06±1.80vs.8.26±1.70,P=0.017),对总体放电信息的显著正经验(β系数，0.43[95CI，0.30至0.56])和住院服务(β系数，0.47[95CI，0.32至0.61]）。此外,实施后调查组的副作用发生率明显较低(11.6%vs.9.0%，P=0.04），两组之间自我报告的服药依从性无统计学差异。
结论：提供关于关键用药风险的书面用药提醒有效地改善了老年患者的体验，并减少了副作用，而没有任何意外的负面后果。这些发现可以为寻求加强老年成年患者出院后护理的类似设置提供参考。未来的研究可以调查其他专业和年龄组的影响，并包括临床结果，以测试该计划的有效性。
方法：在计划实施前后，对每一轮不同的出院患者进行了两轮独立的横断面调查。这项研究纳入了年龄≥65岁的老年患者或他们的照顾者，他们从香港四家试点公立医院的病房出院。患者出院后14天内通过电话进行结构化问卷调查。该调查评估了患者在出院期间对所提供药物信息的体验，包括清晰度，充分性，以及信息的有用性，以及他们在住院服务方面的整体经验。自我报告的服药行为，包括依从性和副作用，也被测量了。
结果：在实施用药提醒前，共收集到1,265份应答，实施后获得1，426份答复。实施前/后调查比较显示，在提供的药物信息的清晰度方面，患者体验有了显著改善(7.93±1.84vs.8.18±1.69,P=0.002),充分性（7.92±1.93vs.8.15±1.76,P=0.014),和有用性(8.06±1.80vs.8.26±1.70,P=0.017),对总体放电信息的显著正经验(β系数，0.43[95CI，0.30至0.56])和住院服务(β系数，0.47[95CI，0.32至0.61]）。此外,实施后调查组的副作用发生率明显较低(11.6%vs.9.0%，P=0.04），两组之间自我报告的服药依从性无统计学差异。
结论：提供关于关键用药风险的书面用药提醒有效地改善了老年患者的体验，并减少了副作用，而没有任何意外的负面后果。这些发现可以为寻求加强老年成年患者出院后护理的类似设置提供参考。未来的研究可以调查其他专业和年龄组的影响，并包括临床结果，以测试该计划的有效性。
