Aim

Medication discrepancies (MDs), defined as unexplained differences among medication regimens, cause important public health problems with clinical and economic consequences. Medication reconciliation (MR) reduces the risk of MDs, but is time consuming and its success relies on the quality of different information sources. Online personalized health records (PHRs) may overcome these drawbacks. Therefore, the aim of this study is to determine the level of agreement of identified MDs between traditional MR and an online PHR and the correctness of the identified MDs with a PHR.

Methods

A prospective cohort study was conducted at the cardiology, neurology, internal medicine and pulmonary department of the Amphia Hospital, the Netherlands. Two weeks prior to a planned admission all patients received an invitation from a PHR to update their medication file derived from the Nationwide Medication Record System (NMRS). At admission MR was performed with all by a pharmacy technician, who created the best possible medication history (BPMH) based on the NMRS data and an interview. MDs were determined as discrepancies between the available information from the NMRS and the input and alterations patients or pharmacy technician made. The number, correctness of patients’ alterations, type and severity of identified MDs were analysed.

Results

Of 488 patients approached, 155 (31.8 %) patients who both used the PHR and had received MR were included. The mean number of MDs identified with MR and PHR was 6.2 (SD 4.3) and 4.7 (SD 3.7), respectively. 82.1 % of the drug information noted by the patient in the PHR was correct compared to the BPMH and 98.6 % had no clinically relevant differences between the lists.

Conclusion

Patients who used an online PHR can relatively accurately record a list of their medication. Further research is required to explore the level of agreement and the correctness of a PHR in other (larger) hospital(departments).

中文翻译：

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药房技术人员进行药物核对与患者使用在线个人健康记录以在选择性入院前识别患者药物清单中的药物差异之间的比较

目标

药物差异（MDs）定义为药物治疗方案之间无法解释的差异，会引起重要的公共卫生问题，并产生临床和经济后果。药物和解（MR）降低了MD的风险，但是很耗时，其成功取决于不同信息源的质量。在线个性化健康记录（PHR）可以克服这些缺点。因此，本研究的目的是确定传统MR与在线PHR之间所确定的MD的一致性水平以及所确定的MD与PHR的正确性。

方法

前瞻性队列研究在荷兰安菲亚医院的心脏病，神经病学，内科和肺科进行。在计划的入院前两周，所有患者都收到了PHR的邀请，以更新其来自全国药物记录系统（NMRS）的药物档案。入院时，MR由药房技术人员全权负责，他们根据NMRS数据和访谈创建了最佳的药物治疗史（BPMH）。MDs被确定为来自NMRS的可用信息与患者或药房技术人员进行的输入和变更之间的差异。分析了患者改变的数量，正确性，所鉴定的MD的类型和严重性。

结果

在488名患者中，包括155名（31.8％）既使用PHR又接受MR的患者。MR和PHR鉴定出的MD的平均数分别为6.2（标准差4.3）和4.7（标准差3.7）。与BPMH相比，患者在PHR中记录的82.1％的药物信息是正确的，并且98.6％的列表之间在临床上无相关差异。

结论

使用在线PHR的患者可以相对准确地记录他们的药物清单。需要进一步的研究来探讨其他（大型）医院（部门）的PHR的协议水平和正确性。