背景:虽然成功的信息传递和无缝的药物供应是医院到家庭过渡期间药物安全的基础,经常报告中断。在德国,新的法律要求于2017年生效,加强药物清单和出院摘要作为信息传递的首选手段。除了以前的规定-例如医院药房出院时分配药物-医院医生现在被允许发布由社区药房提供的出院处方。这项调查研究的目的是在全国范围内首次了解如何实施这些要求以及它们如何影响药物信息传递和持续药物供应的连续性。
方法:从4月17日至6月30日,对德国所有医院和社区药房进行了两次全国性的自我管理在线调查,2023年。
结果:总体而言,所有德国医院药房的31.0%(n=111)和所有社区药房的4.5%(n=811)参加。大多数医院药房报告说,出院的病人通常会得到出院总结(89.2%),药物清单(59.5%),如果需要,出院处方(67.6%)和/或所需药物(67.6%)。大约每第二个社区药房(49.0%)表示,最近出院的患者中,有一半通常会出现药物清单。34.0%的社区药房表示,他们通常每周至少收到一次最近出院的患者的出院摘要。大约四分之三的社区药房(73.3%)表示大多数出院处方都及时发放。然而,三分之一(31.0%)的患者估计有一半以上的患者出现药物供应缺口.社区药房报告了法律要求方面的挑战-例如患者对药物清单的可理解性较差,用药差异,未满足出院处方的正式要求,在查询的情况下,医院工作人员的可及性较差。相比之下,医院药房命名技术问题,时间/人力资源,以及患者对药物治疗知识的不足。
结论:根据药店的看法,可以假设,今天在医院到家庭的过渡期间,药物信息传递的中断和药物供应的缺乏仍然发生,尽管有新的法律要求。需要进一步的研究来补充其他医疗保健专业人员和患者的观点,以确定有效的策略。
BACKGROUND: While successful information transfer and seamless medication supply are fundamental to medication safety during hospital-to-home transitions, disruptions are frequently reported. In Germany, new legal requirements came into force in 2017, strengthening medication lists and discharge summaries as preferred means of information transfer. In addition to previous regulations - such as dispensing medication at discharge by hospital pharmacies - hospital physicians were now allowed to issue discharge prescriptions to be supplied by community pharmacies. The aim of this survey study was to gain first nationwide insights into how these requirements are implemented and how they impact the continuity of medication information transfer and continuous medication supply.
METHODS: Two nationwide self-administered online surveys of all hospital and community pharmacies across Germany were developed and conducted from April 17th to June 30th, 2023.
RESULTS: Overall, 31.0% (n = 111) of all German hospital pharmacies and 4.5% (n = 811) of all community pharmacies participated. The majority of those hospital pharmacies reported that patients who were discharged were typically provided with discharge summaries (89.2%), medication lists (59.5%) and if needed, discharge prescriptions (67.6%) and/or required medication (67.6%). About every second community pharmacy (49.0%) indicated that up to half of the recently discharged patients who came to their pharmacy typically presented medication lists. 34.0% of the community pharmacies stated that they typically received a discharge summary from recently discharged patients at least once per week. About three in four community pharmacies (73.3%) indicated that most discharge prescriptions were dispensed in time. However, one-third (31.0%) estimated that half and more of the patients experienced gaps in medication supply. Community pharmacies reported challenges with the legal requirements - such as patients´ poor comprehensibility of medication lists, medication discrepancies, unmet formal requirements of discharge prescriptions, and poor accessibility of hospital staff in case of queries. In comparison, hospital pharmacies named technical issues, time/personnel resources, and deficits in patient knowledge of medication as difficulties.
CONCLUSIONS: According to the pharmacies´ perceptions, it can be assumed that discontinuation in medication information transfer and lack of medication supply still occur today during hospital-to-home transitions, despite the new legal requirements. Further research is necessary to supplement these results by the perspectives of other healthcare professionals and patients in order to identify efficient strategies.