Inpatient self-administered medication under the supervision of a multidisciplinary team: a randomized, controlled, blinded parallel trial
Fuente:
Redalyc
Guardado en:
| Autor principal: | |
|---|---|
| Formato: | Artículo científico |
| Lenguaje: | en |
| Publicado: |
Centro de investigaciones y Publicaciones Farmacéuticas
2020
|
| Materias: | |
| Acceso en línea: | |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| _version_ | 1876475368277278720 |
|---|---|
| author | Ronee Kaday |
| author_facet | Ronee Kaday |
| contents | Inpatient self-administered medication under the supervision of a multidisciplinary team: a randomized, controlled, blinded parallel trial Ronee Kaday Chaveewan Ratanajamit Medicina Thailand Hospitalization Medication Errors Patient Discharge Patient Care Team Background: Self-administered medication (SAM) is encouraged in many hospitals worldwide as it increases patients’ knowledge and understanding of their medication, but the effects on other outcomes, e.g. compliance or medication errors, were unclear. Objectives: To compare medication knowledge, adherence, medication errors, and hospital readmission among inpatients receiving SAM education under the supervision of a multidisciplinary team (study group) with those receiving routine nurse-administered medication (control group). Methods: This study was a PROBE design. Inpatients with chronic diseases were randomly allocated (1:1) to either the study group or the control group using stratified-block randomization. Knowledge of medications was measured at hospital discharge and at the first two follow-up visits; adherence was measured at the first two follow-up visits, medication errors while in hospital, and hospital readmission within 60 days after discharge. For normally distributed continuous outcomes, mean difference and 95%CI were estimated; otherwise the median and the Mann-Whitney test p-value were reported. The percentage difference and 95%CI were reported for binary outcomes. Results: 70 patients were randomized (35 in each group); all received complete follow-up. Both groups were similar at baseline. Mean (SD) age (years) were 59.2 (11.0) for the study group and 58.3 (12.0) for the control group. Percentages of females in the respective groups were 54.3 and 60.0. Mean time from discharge to the first follow-up visit was two weeks in both groups and time to the second follow-up visit were 68.8 days (study group) and 55.0 days (control group). The study group had significantly higher medication knowledge than the control group at hospital discharge (of the 10-point scale, medians, 8.56 and 6.18, respectively, p<0.001). The corresponding figures were similar in both groups at the first follow-up visit (medians, 8.25 and 6.26, respectively, p<0.001). Adherence to medication at the first visit in the study group (percentage mean 92.50% (SD=5.33%)) was significantly higher than that in the control group (79.60% (SD=5.96%)), percentage mean difference 12.90%, [95%CI 10.20%:15.60%], p<0.001. Medication knowledge and adherence were sustained at the second follow-up visit. During hospitalization, no medication errors were found in the study group, and minimal errors occurred in the control group (1.48%, [95%CI 0.68%:2.28%] of doses administered, p=0.001). Hospital readmission within 60 days after discharge was significantly lower in the study group (11.4%) than that in the control group (31.4%), percentage difference 20.0% (95%CI 1.4%:38.6%), 1-side Fisher exact p=0.039. Conclusions: Among in-patients with chronic diseases, SAM program significantly increased knowledge of and adherence to prescribed medications. Medication errors regarding administration errors were infrequent but significantly higher in the control group. SAM reduced hospital readmi 2020 artículo científico 1885-642X https://www.redalyc.org/articulo.oa?id=69065537002 https://www.redalyc.org/journal/690/69065537002/ https://www.redalyc.org/journal/690/69065537002/html/ https://www.redalyc.org/journal/690/69065537002/69065537002.epub https://www.redalyc.org/journal/690/69065537002/movil 10.18549/PharmPract.2020.2.1766 en http://www.redalyc.org/revista.oa?id=690 Pharmacy Practice application/pdf Centro de investigaciones y Publicaciones Farmacéuticas Pharmacy Practice (España) Num.2 Vol.18 |
| format | Artículo científico |
| id | redalyc_69065537002 |
| institution | Redalyc |
| language | en |
| publishDate | 2020 |
| publisher | Centro de investigaciones y Publicaciones Farmacéuticas |
| spellingShingle | Inpatient self-administered medication under the supervision of a multidisciplinary team: a randomized, controlled, blinded parallel trial Ronee Kaday Medicina Thailand Hospitalization Medication Errors Patient Discharge Patient Care Team Inpatient self-administered medication under the supervision of a multidisciplinary team: a randomized, controlled, blinded parallel trial Ronee Kaday Chaveewan Ratanajamit Medicina Thailand Hospitalization Medication Errors Patient Discharge Patient Care Team Background: Self-administered medication (SAM) is encouraged in many hospitals worldwide as it increases patients’ knowledge and understanding of their medication, but the effects on other outcomes, e.g. compliance or medication errors, were unclear. Objectives: To compare medication knowledge, adherence, medication errors, and hospital readmission among inpatients receiving SAM education under the supervision of a multidisciplinary team (study group) with those receiving routine nurse-administered medication (control group). Methods: This study was a PROBE design. Inpatients with chronic diseases were randomly allocated (1:1) to either the study group or the control group using stratified-block randomization. Knowledge of medications was measured at hospital discharge and at the first two follow-up visits; adherence was measured at the first two follow-up visits, medication errors while in hospital, and hospital readmission within 60 days after discharge. For normally distributed continuous outcomes, mean difference and 95%CI were estimated; otherwise the median and the Mann-Whitney test p-value were reported. The percentage difference and 95%CI were reported for binary outcomes. Results: 70 patients were randomized (35 in each group); all received complete follow-up. Both groups were similar at baseline. Mean (SD) age (years) were 59.2 (11.0) for the study group and 58.3 (12.0) for the control group. Percentages of females in the respective groups were 54.3 and 60.0. Mean time from discharge to the first follow-up visit was two weeks in both groups and time to the second follow-up visit were 68.8 days (study group) and 55.0 days (control group). The study group had significantly higher medication knowledge than the control group at hospital discharge (of the 10-point scale, medians, 8.56 and 6.18, respectively, p<0.001). The corresponding figures were similar in both groups at the first follow-up visit (medians, 8.25 and 6.26, respectively, p<0.001). Adherence to medication at the first visit in the study group (percentage mean 92.50% (SD=5.33%)) was significantly higher than that in the control group (79.60% (SD=5.96%)), percentage mean difference 12.90%, [95%CI 10.20%:15.60%], p<0.001. Medication knowledge and adherence were sustained at the second follow-up visit. During hospitalization, no medication errors were found in the study group, and minimal errors occurred in the control group (1.48%, [95%CI 0.68%:2.28%] of doses administered, p=0.001). Hospital readmission within 60 days after discharge was significantly lower in the study group (11.4%) than that in the control group (31.4%), percentage difference 20.0% (95%CI 1.4%:38.6%), 1-side Fisher exact p=0.039. Conclusions: Among in-patients with chronic diseases, SAM program significantly increased knowledge of and adherence to prescribed medications. Medication errors regarding administration errors were infrequent but significantly higher in the control group. SAM reduced hospital readmi 2020 artículo científico 1885-642X https://www.redalyc.org/articulo.oa?id=69065537002 https://www.redalyc.org/journal/690/69065537002/ https://www.redalyc.org/journal/690/69065537002/html/ https://www.redalyc.org/journal/690/69065537002/69065537002.epub https://www.redalyc.org/journal/690/69065537002/movil 10.18549/PharmPract.2020.2.1766 en http://www.redalyc.org/revista.oa?id=690 Pharmacy Practice application/pdf Centro de investigaciones y Publicaciones Farmacéuticas Pharmacy Practice (España) Num.2 Vol.18 |
| title | Inpatient self-administered medication under the supervision of a multidisciplinary team: a randomized, controlled, blinded parallel trial |
| topic | Medicina Thailand Hospitalization Medication Errors Patient Discharge Patient Care Team |
| url | https://www.redalyc.org/articulo.oa?id=69065537002 https://www.redalyc.org/journal/690/69065537002/ https://www.redalyc.org/journal/690/69065537002/html/ https://www.redalyc.org/journal/690/69065537002/69065537002.epub https://www.redalyc.org/journal/690/69065537002/movil |