Improving safety and efficacy with pharmacist medication reconciliation in orthopedic joint surgery within an enhanced recovery after surgery program

作者全名："Zheng, Xiaoying; Xiao, Lei; Li, Ying; Qiu, Feng; Huang, Wei; Li, Xinyu"

作者地址："[Zheng, Xiaoying; Qiu, Feng; Li, Xinyu] Chongqing Med Univ, Affiliated Hosp 1, Dept Pharm, 1 Youyi Rd, Chongqing, Peoples R China; [Xiao, Lei; Huang, Wei] Chongqing Hlth Ctr Women & Children, Dept Pharm, Chongqing, Peoples R China; [Li, Ying; Huang, Wei] Chongqing Med Univ, Affiliated Hosp 1, Dept Orthoped Surg, Chongqing, Peoples R China"

通信作者："Li, XY (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Pharm, 1 Youyi Rd, Chongqing, Peoples R China."

来源：BMC HEALTH SERVICES RESEARCH

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000779139000003

JCR分区：Q2

影响因子：2.8

年份：2022

卷号：22

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Medication reconciliation; Medication discrepancy; Enhanced recovery after surgery; Periprosthetic joint infection

摘要："Purpose: To investigate the impact of medication reconciliation (MR), through avoidance of unintentional medication discrepancies, on enhanced recovery after surgery programs designed for older patients undergoing orthopedic joint surgery. Method: Our study was divided into two phases. In the first phase, MR was performed for elderly patients undergoing orthopedic joint surgery. Types of medication discrepancies and their potential risks were analyzed. In the second phase, a controlled study was conducted in a subgroup of patients diagnosed with periprosthetic joint infection (PJI) and who were scheduled for two-stage revision. The primary goal was to investigate the impact of MR on length of stay for the first stage. The secondary goal was to investigate the time between the first admission and the reimplantation of a new prosthesis, the number of readmissions within 30 days, hospitalization cost. Results: A total of 506 medication discrepancies were identified in the included 260 patients. Intolerance had the highest incidence (n = 131, 25.7%). The Bayliff tool showed that 71.9% were assessed as level 2 risk, and 10.3% had a life-threatening risk. For patients with PJI, MR reduced the average length of stay in the first stage (16.3 days vs. 20.7 days, P = 0.03) and shortened the time (57.3 days vs. 70.5 days, P = 0.002) between the first admission and the reimplantation of a new prosthesis. The average cost of hospital stay ($8589.6 vs. $10,422.6, P = 0.021), antibiotics ($1052.2 vs. $1484.7, P = 0.032) and other medications ($691.5 vs. $1237.6, P = 0.014) per patient at our hospital were significantly decreased. Notably, significant improvements in patient satisfaction were seen in participants in the MR group. Conclusion: Through MR by clinical pharmacists, medication discrepancies within the orthopedic ERAS program could be identified. For patients with periprosthetic joint infection, better patient satisfaction and clinical and economical outcomes can be achieved with this method."

基金机构：Natural Science Foundation of Chongqing [cstc2019jcyj-msxmX0287]; Scientific and Health Joint Medical Research Project of Chongqing [2021MSXM113]

基金资助正文："This work was supported by grants from Natural Science Foundation of Chongqing (cstc2019jcyj-msxmX0287), Scientific and Health Joint Medical Research Project of Chongqing(2021MSXM113) to Xinyu Li."