دورية أكاديمية
What works in medication reconciliation: an on-treatment and site analysis of the MARQUIS2 study
| العنوان: | What works in medication reconciliation: an on-treatment and site analysis of the MARQUIS2 study |
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| المؤلفون: | Schnipper, Jeffrey L, Reyes Nieva, Harry, Yoon, Catherine, Mallouk, Meghan, Mixon, Amanda S, Rennke, Stephanie, Chu, Eugene S, Mueller, Stephanie K, Smith, G Randy, Williams, Mark V, Wetterneck, Tosha B, Stein, Jason, Dalal, Anuj K, Labonville, Stephanie, Sridharan, Anirudh, Stolldorf, Deonni P, Orav, Endel John, Gresham, Marcus, Goldstein, Jenna, Platt, Sara, Nyenpan, Christopher Tugbéh, Howell, Eric, Kripalani, Sunil, MARQUIS2 Site Leaders for the MARQUIS2 Study Group, MARQUIS2 Site Leaders, Sen, Sanchita, SamerBadr, Michelle Murphy, Vasilopoulos, Corrie, Vlasimsky, Tara, Roussel, Christine, Arole, Olugbenga, Berescu, Loredana Diana, Arifuddowla, Arif, Main, Hattie, Pickle, Susan, Singleton, Cristy, Asplund, Brenda, Delrue, Andrea, Forgione, Andrea, Shipman, Colleen, Brunetti, Luigi, Ahmed, Hina, Gonzales, Adrian, MithuMolla, Sarah Bojerek, Nguyen, Andrea, El-Kareh, Robert |
| بيانات النشر: | BMJ Publishing Group Ltd |
| سنة النشر: | 2023 |
| المجموعة: | HighWire Press (Stanford University) |
| مصطلحات موضوعية: | Original research |
| الوصف: | Background The second Multicenter Medication Reconciliation Quality Improvement Study demonstrated a marked reduction in medication discrepancies per patient. The aim of the current analysis was to determine the association of patient exposure to each system-level intervention and receipt of each patient-level intervention on these results. Methods This study was conducted at 17 North American Hospitals, the study period was 18 months per site, and sites typically adopted interventions after 2–5 months of preintervention data collection. We conducted an on-treatment analysis (ie, an evaluation of outcomes based on patient exposure) of system-level interventions, both at the category level and at the individual component level, based on monthly surveys of implementation site leads at each site (response rate 65%). We then conducted a similar analysis of patient-level interventions, as determined by study pharmacist review of documented activities in the medical record. We analysed the association of each intervention on the adjusted number of medication discrepancies per patient in admission and discharge orders, based on a random sample of up to 22 patients per month per site, using mixed-effects Poisson regression with hospital site as a random effect. We then used a generalised linear mixed-effects model (GLMM) decision tree to determine which patient-level interventions explained the most variance in discrepancy rates. Results Among 4947 patients, patient exposure to seven of the eight system-level component categories was associated with modest but significant reductions in discrepancy rates (adjusted rate ratios (ARR) 0.75–0.97), as were 15 of the 17 individual system-level intervention components, including hiring, reallocating and training personnel to take a best possible medication history (BPMH) and training personnel to perform discharge medication reconciliation and patient counselling. Receipt of five of seven patient-level interventions was independently associated with large reductions in ... |
| نوع الوثيقة: | text |
| وصف الملف: | text/html |
| اللغة: | English |
| العلاقة: | http://qualitysafety.bmj.com/cgi/content/short/32/8/457Test; http://dx.doi.org/10.1136/bmjqs-2022-014806Test |
| DOI: | 10.1136/bmjqs-2022-014806 |
| الإتاحة: | https://doi.org/10.1136/bmjqs-2022-014806Test http://qualitysafety.bmj.com/cgi/content/short/32/8/457Test |
| حقوق: | Copyright (C) 2023, BMJ Publishing Group Ltd |
| رقم الانضمام: | edsbas.F3ABC168 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1136/bmjqs-2022-014806 |
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