背景:eConsults在全球范围内越来越多地用于减少专家转诊并增加获得医疗服务的机会。使用eConsult工具的另一个好处是降低医疗保健成本,同时提高医疗保健质量和患者参与。目前,共享决策越来越受到患者的实施和首选。eConsults也是一个有希望的工具,以改善与医院药剂师的接触。患者经常对他们的药物有疑问。当在入院或门诊就诊期间开始用药时,社区药剂师并不总是足够了解来回答患者的问题。与医院药剂师直接接触可能更合适,更有效。通过医院患者门户中的eConsult功能促进此联系。
目的:本研究旨在评估患者发送给医院药师的eConsults的患病率和内容。
方法:在荷兰莱顿大学医学中心进行了首次回顾性描述性研究。包括在2017年3月至2021年12月期间向医院药剂师发送至少一名eConsult的患者。从电子健康记录中提取患者特征和服用药物的数量。分析了eConsults的内容并将其分为不同的主题。分析了发送eConsults的时间。比较了发送到医院药房的eConsults的数量和发送到医疗中心的数量。最后,所有eConsults都评估了医院药剂师评估的适当性.
结果:在研究期间,983个eConsults(来自808名患者)被送到医院药剂师。患者平均年龄为56(SD15.9)岁,51.4%(415/808)为男性;47.8%(386/808)的患者使用0至4种药物,33.0%(267/808)使用5至9种药物,19.2%(155/808)使用≥10种药物。在eConsults中,10.9%(107/983)由于与药物无关或不适合医院药剂师而被排除。在31个医学专业接受治疗的患者向医院药剂师发送了eConsults。最常见的医学专业是心脏病学,占eConsults的22.5%(197/876)。大多数eConsults是在办公时间内发送的(614/876,70.2%)。eConsult受试者进行了药物验证(372/876,42.5%),物流(243/876,27.7%),治疗效果和不良事件(100/876,11.4%),使用药物(87/876,9.9%),和其他科目(74/876,8.4%)。
结论:引入eConsults允许患者直接向医院药剂师询问药物相关问题。我们的研究表明,患者最常发送药物和解相关的eConsults。使用eConsult工具可以快速、直接,并记录了患者和医院药剂师之间的沟通。这可以减少与药物相关的错误,改善患者赋权,并增加与医院药剂师的联系。
BACKGROUND: eConsults are increasingly used worldwide to reduce specialist referrals and increase access to medical care. An additional benefit of using an eConsult tool is a reduction of health care costs while improving the quality of health care and patient participation. Currently, shared decision making is increasingly implemented and preferred by patients. eConsults are also a promising tool to improve access to the hospital pharmacist. Patients often have questions about their medication. When medication is started during a hospital admission or outpatient visit, community pharmacists are not always sufficiently informed to answer patient questions. Direct contact with hospital pharmacists may be more appropriate and efficient. This contact is facilitated through the eConsult feature in the hospital\'s patient portal.
OBJECTIVE: This study aims to evaluate the prevalence and contents of the eConsults sent by patients to hospital pharmacists.
METHODS: A first retrospective descriptive study was conducted at the Leiden University Medical Center in the Netherlands. Patients who sent at least one eConsult to a hospital pharmacist between March 2017 and December 2021 were included. Patient characteristics and the number of medications taken were extracted from electronic health records. The content of eConsults was analyzed and grouped into different subjects. Time of sending of the eConsults was analyzed. A comparison was made between the number of eConsults sent to the hospital pharmacy and the number sent to the medical center. Finally, the appropriateness for evaluation by the hospital pharmacist was assessed in all eConsults.
RESULTS: During the study period, 983 eConsults (from 808 patients) were sent to the hospital pharmacist. The average patient age was 56 (SD 15.9) years, and 51.4% (415/808) were male; 47.8% (386/808) of the patients used 0 to 4 medications, 33.0% (267/808) used 5 to 9 medications, and 19.2% (155/808) used ≥10 medications. Of the eConsults, 10.9% (107/983) were excluded due to not being medication-related or not intended for the hospital pharmacist. Patients being treated in 31 medical specialties sent eConsults to the hospital pharmacist. The most common medical specialty was cardiology with 22.5% (197/876) of the eConsults. Most eConsults were sent during office hours (614/876, 70.2%). eConsult subjects were medication verification (372/876, 42.5%), logistics (243/876, 27.7%), therapeutic effect and adverse events (100/876, 11.4%), use of medication (87/876, 9.9%), and other subjects (74/876, 8.4%).
CONCLUSIONS: Introducing eConsults allows patients to ask medication-related questions directly to hospital pharmacists. Our study shows that patients send medication reconciliation-related eConsults most often. Use of the eConsult tool leads to fast, direct, and documented communication between patient and hospital pharmacist. This can reduce medication-related errors, improve patient empowerment, and increase access to the hospital pharmacist.