Patientensicherheitsindikatoren zur Arzneimitteltherapiesicherheit (AMTS-PSI): Internationaler Status, Übertragbarkeit und Validierung

Kuske, Silke; Lessing, Constanze; Lux, Richard; Schmitz, Anna; Schrappe, Matthias

doi:10.1055/s-0030-1269838

Cited by 15 publications

(6 citation statements)

References 7 publications

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“…The majority of the included studies originated from Germany (18/30 studies, 60%), followed by the USA (5), Australia (3), UK (2), Ireland (1) and Switzerland (1). Study designs (by decreasing order of evidence 28 ) were: 1 systematic review, 29 4 randomised controlled trials (RCT), 30–33 10 cohort studies, 34–43 7 cross-sectional studies, 5 44–49 2 qualitative evaluations, 4 50 4 surveys 51–54 and 2 reports. 55 56 Thirteen studies reported statistically significant results with the use of medication charts.…”

Section: Resultsmentioning

confidence: 99%

“…In the systematic review on safety-relevant indicators, a medication chart was identified as one out of 14 parameters to ensure medication safety as well as patient safety. 29 Over 80% of the patients (N=138) in an RCT indicated that the medication chart helped them ‘avoid making mistakes with medications’ that were further described as medication intake errors such as wrong time, wrong pill or missed pill. 30 Another study measured a significant reduction of missed or delayed medication doses per patient after the implementation of a medication chart at discharge from hospital to nursing homes (from 37/202; 18.3% missed or delayed doses, to 6/226; 2.7%, p<0.001).…”

Section: Resultsmentioning

confidence: 99%

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Benefits of medication charts provided at transitions of care: a narrative systematic review

2020

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ObjectivesParticularly at transitions of care points information concerning current medication tends to be incomplete. A medication chart that contains all essential information on current therapy is likely to be a helpful tool for patients and healthcare providers. We aimed to investigate any type of benefits associated with medication charts provided at transition points.MethodsA systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed. Two databases, two online journals and two association websites dedicated to biomedicine and pharmacy issues were consulted to identify studies for the review using the search term ‘medication chart’ and synonyms. We run our search from database inception up to March 2019. Studies of any study design, intervention and population which examined the effect of paper-based medication charts were included. We extracted study results narratively and coded and classified them by themes and categories inductively by using the ‘framework method’ with content analysis. The methodological quality of the studies was assessed using the Effective Public Health Practice Project (EPHPP) tool.ResultsFrom the 846 retrieved articles, 30 studies met the inclusion criteria, mostly from Germany (18 studies) and the USA (5 studies). Thirteen studies reported a statistically significant result. In the ‘patient theme’, the most obvious benefits were an increase in medication knowledge, a reduction of medication errors and higher medication adherence. In the ‘interdisciplinary theme’, a medication chart represented a helpful tool to increase communication and inter-sectoral cooperation between healthcare providers. In the ‘theme of terms and conditions’, accuracy and currency of data are prerequisites for any positive effect. The quality of the studies was classified predominantly weak mainly due to unmet good quality criteria (no randomised controlled trials study design, no reported dropouts).ConclusionOverall, the reviewed studies suggested some benefits when using medication charts. Healthcare providers could consider using medication charts in their counselling practice. However, it is unknown whether the reported benefits lead to measurable improvement in clinical outcomes.PROSPERO registration number

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Benefits of medication charts provided at transitions of care: a narrative systematic review

2020

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“…The reasons extend to the identi cation and resolution of drug-related problems including also inadequate communication across care interfaces. For this purpose, informing the patients on their medication by listing it on a (standardized) medication plan (MP) with all relevant information may prevent many of those problems and MPs have been identi ed as a relevant factor for patient safety [ 2 , 3 ]. Additionally, it was shown that further information, especially on handling, helps to improve patient knowledge about medication compared to control groups with only standard information [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Implementing standardized medication plans in ambulatory care – Are they correct and do patients follow their plan?

Eickhoff

Müller

Thomas

et al. 2023

Preprint

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Purpose The standardized medication plan (MP) is a document listing the patients’ entire medication, instructions for use, and indications in a nationally defined format. However, there is currently little data on its practical implementation, comprehensibility, and use at the patient level. We aimed to investigate under routine conditions (i) patients’ competencies in using the MP, (ii) completeness and correctness of the MP including handwritten modifications, and (iii) patients’ reasons for deviating from the MP. Methods We conducted face-to-face interviews with patients in community pharmacies. Data was analyzed with qualitative and quantitative methods. Results We enrolled 288 patients (median age: 76 years, range: 27–95) with n=2,779 medications actually taken and n=2,539 medications documented on the MPs. 38.5% of the patients used their MP regularly to prepare their medication and 73.3% used it to inform their physician. (i) Overall, patients’ orientation and understanding the MP was good. (ii) No MP was correct and complete. When taking only relevant aspects into account, i.e. active ingredient, strength, dosage, medication missing or listed but not taken, 79.2% (n=228) were incorrect or incomplete. With 25.8% of the total number of handwritten modifications (n=341) most often medications were added. (iii) Almost 60% of all patients deliberately deviated from their MP, “fear of adverse drug reactions” was the most frequently (n=50) mentioned reason. Conclusion The patients’ competence in understanding their MP was good. However, important information was often missing or incorrect; therefore, handwritten modifications were frequently added. Patients often deliberately deviated from their MP for various reasons.

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“…Der fehlende Überblick über die Gesamtmedikation des Patienten ist eine häufige Ursache von Medikationsfehlern [3]; kritische Situationen wie Interaktionen oder unerwünschte Arzneimittelwirkungen werden dadurch häufig nicht rechtzeitig erkannt. Eine Lösung hierfür ist die interprofessionelle Nutzung eines Medikationsplans (MP) [4]. In Deutschland wurde im Rahmen der Aktionspläne zur Verbesserung der Arzneimitteltherapiesicherheit (AMTS) des Bundesministeriums für Gesundheit (BMG) ein Standard für einen solchen MP entwickelt, der sogenannte bundeseinheitliche Medikationsplan (BMP) [5].…”

Section: Introductionunclassified

Das Projekt PRIMA – Elektronische Erstellung und Aktualisierung von Medikationsplänen als gemeinsame Aufgabe von Ärzten und Apothekern

Eickhoff

Müller

Strunz

et al. 2019

Dtsch med Wochenschr

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Zusammenfassung Einleitung Der Gesamtüberblick über die Medikation eines Patienten ist wesentliche Voraussetzung für die Arzneimitteltherapiesicherheit. Ein aktueller und vollständiger Medikationsplan (MP) ist hierfür ein geeignetes Instrument. Ziel war zu untersuchen, inwiefern die elektronische Bearbeitung des bundeseinheitlichen Medikationsplans gemeinsam durch Arzt und Apotheker in ihren Primärsystemen technisch machbar ist, die definierten Prozesse praktikabel sind und akzeptiert werden. Methoden Ärzte und Apotheker testeten in einem mehrstufigen Verfahren die elektronische Umsetzung. Die Bearbeitung der MP erfolgte anhand definierter Prozesse und Verantwortlichkeiten; Machbarkeit und Akzeptanz wurden in schriftlichen Befragungen und einem Workshop evaluiert. Ergebnisse Erstmalig in Deutschland wurden die Voraussetzungen zur elektronischen Erstellung, zum Austausch und zur Aktualisierung von MP in einem Arzt- und vier Apothekenverwaltungssystemen geschaffen. Gelöste Probleme waren technische und AMTS-relevante Fehler, abweichende Darstellungen, mangelnde Benutzerfreundlichkeit und begrenzte Speicherkapazität des Barcodes. Elf Arzt-Apotheker-Teams betreuten 196 Patienten. Insgesamt waren 60 % mit den Prozessen und 80 % der Ärzte sowie 63 % der Apotheker mit den Verantwortlichkeiten zufrieden. Ärzte bewerteten die Erfassung der Gesamtmedikation durch Apotheker positiv. Die Kooperation verbesserte den fachlichen Austausch. Dies führt bei 70 % der Ärzte bei der Medikation und bei 88 % der Apotheker zum Gesundheitszustand der Patienten zu einem Wissenszuwachs. Alle Ärzte und Apotheker sahen eine strukturierte Zusammenarbeit als wichtig (25 %) oder sehr wichtig (75 %) für die Qualität der MP an. Diskussion Der MP wurde erstmalig in Primärsysteme implementiert. Prozesse und Verantwortlichkeiten fanden bei Ärzten und Apothekern Akzeptanz. Dies sind wichtige Voraussetzungen, um den MP flächendeckend und nachhaltig zu implementieren.

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Patientensicherheitsindikatoren zur Arzneimitteltherapiesicherheit (AMTS-PSI): Internationaler Status, Übertragbarkeit und Validierung

Cited by 15 publications

References 7 publications

Benefits of medication charts provided at transitions of care: a narrative systematic review

Benefits of medication charts provided at transitions of care: a narrative systematic review

Implementing standardized medication plans in ambulatory care – Are they correct and do patients follow their plan?

Das Projekt PRIMA – Elektronische Erstellung und Aktualisierung von Medikationsplänen als gemeinsame Aufgabe von Ärzten und Apothekern

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