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首页> 外文期刊>BMC Health Services Research >The effect of an active on-ward participation of hospital pharmacists in Internal Medicine teams on preventable Adverse Drug Events in elderly inpatients: protocol of the WINGS study (Ward-oriented pharmacy in newly admitted geriatric seniors)
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The effect of an active on-ward participation of hospital pharmacists in Internal Medicine teams on preventable Adverse Drug Events in elderly inpatients: protocol of the WINGS study (Ward-oriented pharmacy in newly admitted geriatric seniors)

机译：医院药剂师积极参与内科团队对老年住院患者可预防的不良药物事件的影响：WINGS研究方案（新入院老年患者的面向病房药房）

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Background The potential of clinical interventions, aiming at reduction of preventable Adverse Drug Events (preventable ADEs) during hospital stay, have been studied extensively. Clinical Pharmacy is a well-established and effective service, usually consisting of full-time on-ward participation of clinical pharmacists in medical teams. Within the current Hospital Pharmacy organisation in the Netherlands, such on-ward service is less feasible and therefore not yet established. However, given the substantial incidence of preventable ADEs in Dutch hospitals found in recent studies, appears warranted. Therefore, "Ward-Oriented Pharmacy", an on-ward service tailored to the Dutch hospital setting, will be developed. This service will consist of multifaceted interventions implemented in the Internal Medicine wards by hospital pharmacists. The effect of this service on preventable ADEs in elderly inpatients will be measured. Elderly patients are at high risk for ADEs due to multi-morbidity, concomitant disabilities and polypharmacy. Most studies on the incidence and preventability of ADEs in elderly patients have been conducted in the outpatient setting or on admission to a hospital, and fewer in the inpatient setting. Moreover, recognition of ADEs by the treating physicians is challenging in elderly patients because their disease presentation is often atypical and complex. Detailed information about the performance of the treating physicians in ADE recognition is scarce. Methods/Design The design is a multi-centre, interrupted time series study. Patients of 65 years or older, consecutively admitted to Internal Medicine wards will be included. After a pre-measurement, a Ward-Oriented Pharmacy service will be introduced and the effect of this service will be assessed during a post-measurement. The primary outcome measures are the ADE prevalence on admission and ADE incidence during hospital stay. These outcomes will be assessed using structured retrospective chart review by an independent expert panel. This assessment will include determination of causality, severity and preventability of ADEs. In addition, the extent to which ADEs are recognised and managed by the treating physicians will be considered. Discussion The primary goal of the WINGS study is to assess whether a significant reduction in preventable ADEs in elderly inpatients can be achieved by a Ward-Oriented Pharmacy service offered. A comprehensive ADE detection method will be used based on expert opinion and retrospective, trigger-tool enhanced, chart review. Trial registration ISRCTN: ISRCTN64974377
机译：背景技术为减少住院期间可预防的不良药物事件（可预防的ADEs）的临床干预潜力已得到广泛研究。临床药房是一项完善的有效服务，通常由临床药师全天候参与医疗团队组成。在荷兰当前的医院药房组织内，这种上门服务不太可行，因此尚未建立。但是，鉴于最近的研究发现荷兰的医院中可预防ADE的发生率很高，因此看来是有必要的。因此，将开发针对荷兰医院环境的“面向服务的药房”。该服务将包括医院药剂师在内科病房实施的多方面干预措施。将测量这项服务对老年住院患者可预防的ADEs的影响。老年患者由于多种疾病，伴随残疾和多药治疗而发生ADE的风险较高。大多数有关老年患者ADEs发生率和可预防性的研究是在门诊或入院时进行的，而在住院中则较少。此外，在老年患者中，主治医师对ADE的识别具有挑战性，因为他们的疾病表现通常是非典型且复杂的。缺乏有关治疗医生在ADE识别中的表现的详细信息。方法/设计设计是一个多中心，不连续的时间序列研究。包括连续入院内科病房的65岁或65岁以上的患者。在进行预测量后，将引入面向病房的药房服务，并在后测量期间评估该服务的效果。主要的结局指标是住院期间的ADE患病率和住院期间的ADE发生率。这些结果将由独立专家小组使用结构化的回顾性图表审查进行评估。该评估将包括确定ADE的因果关系，严重性和可预防性。另外，将考虑主治医师认可和管理ADE的程度。讨论WINGS研究的主要目标是评估通过提供的病房导向药房服务能否实现老年住院患者可预防ADE的显着减少。将基于专家意见和回顾性，增强的触发工具以及图表审查功能，使用全面的ADE检测方法。试用注册ISRCTN：ISRCTN64974377

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