약사 업무의 표준화를 위한 입원환자의 의약품 처방 검토 및 약물 조정 제고: 지참약관리 및 다약제 사용관리를 중심으로
Enhancement of Inpatient Medication Review and Reconciliation through Standardization of Pharmacist Practice: Focusing on the Management of Outpatient Medication upon Admission and Polypharmacy
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Background : Reflecting the reality of the absence of standardized guidelines for the specifics and procedures of inpatient medication review tasks conducted by pharmacists in hospitals, it is now imperative to define key elements by assessing the current situation and awareness. Methods : We analyzed pharmacists’ inpatient medication review and reconciliation tasks to establish standard elements, including the core concept. General-purpose recommendations were derived from a survey on the current status and awareness of these elements. Literature and guideline research, along with a focus group interview, helped to derive detailed task elements. A survey assessed task element priorities and institutional performance, with key items determined from the results. Results : Thirty-nine organizations participated in the importance-performance survey, and 46 organizations participated in the priority survey. Most task elements were evaluated with low scores for performance compared to importance awareness. The task elements were classified into “division of task,” “qualification requirements for pharmacists,” “patient selection,” “task scope,” “timing of work implementation,” and “task index.” Twelve of 22 elements were derived as key tasks (e.g., task scope and timing). The task scope was subdivided into medical history review, patient counseling, multidisciplinary team involvement, and medication reconciliation. A total of 33 of 51 task elements were identified as major performance items (e.g., medication review and reconciliation). Conclusion : Based on the study results, major tasks were derived for the medication review and reconciliation of hospitalized patients. Recognized standard guidelines should be considered as the medical paradigm changes. In this regard, efforts to establish various task elements can improve patient safety and treatment outcomes.
Abstract
Background : Reflecting the reality of the absence of standardized guidelines for the specifics and procedures of inpatient medication review tasks conducted by pharmacists in hospitals, it is now imperative to define key elements by assessing the current situation and awareness. Methods : We analyzed pharmacists’ inpatient medication review and reconciliation tasks to establish standard elements, including the core concept. General-purpose recommendations were derived from a survey on the current status and awareness of these elements. Literature and guideline research, along with a focus group interview, helped to derive detailed task elements. A survey assessed task element priorities and institutional performance, with key items determined from the results. Results : Thirty-nine organizations participated in the importance-performance survey, and 46 organizations participated in the priority survey. Most task elements were evaluated with low scores for performance compared to importance awareness. The task elements were classified into “division of task,” “qualification requirements for pharmacists,” “patient selection,” “task scope,” “timing of work implementation,” and “task index.” Twelve of 22 elements were derived as key tasks (e.g., task scope and timing). The task scope was subdivided into medical history review, patient counseling, multidisciplinary team involvement, and medication reconciliation. A total of 33 of 51 task elements were identified as major performance items (e.g., medication review and reconciliation). Conclusion : Based on the study results, major tasks were derived for the medication review and reconciliation of hospitalized patients. Recognized standard guidelines should be considered as the medical paradigm changes. In this regard, efforts to establish various task elements can improve patient safety and treatment outcomes.
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