A newly developed algorithm for switching outpatient medications to medications listed in the hospital formulary: a prospective real-word evaluation in patients admitted electively to hospital.

Purpose: In many countries, outpatient and inpatient care are separated. During hospitalization, therefore, switching the outpatient medication to medication of the hospital formulary is required. Methods: We newly designed a switching algorithm in six switching steps (S0–S5) and conducted a study a...

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Publicado en:European Journal of Clinical Pharmacology Vol. 80; no. 8; pp. 1197 - 1208
Autores principales: Möller, Finja, Oetting, Malte, Spiegel, Andreas, Zube, Olaf, Bertsche, Thilo
Formato: algorithm research tables/charts Journal Article
Publicado: Springer Nature Aug2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2024
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      pub: Springer Nature
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        10.1007/s00228-024-03682-w
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        atl: A newly developed algorithm for switching outpatient medications to medications listed in the hospital formulary: a prospective real-word evaluation in patients admitted electively to hospital.
      aug:
        au:
          Möller, Finja
          Oetting, Malte
          Spiegel, Andreas
          Zube, Olaf
          Bertsche, Thilo
        affil: Pharmacy Department, Bundeswehr Hospital Hamburg, Hamburg, Germany
      sug:
        subj:
          Algorithms Utilization
          Medication Reconciliation
          Drug Substitution
          Hospitalization
          Formularies
          Human
          Middle Age
          Aged
          Aged, 80 and Over
          Prospective Studies
          Germany
          Drug Interactions
          Descriptive Statistics
          Medication Review
          Outpatients
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
      ab: Purpose: In many countries, outpatient and inpatient care are separated. During hospitalization, therefore, switching the outpatient medication to medication of the hospital formulary is required. Methods: We newly designed a switching algorithm in six switching steps (S0–S5) and conducted a study at Bundeswehr Hospital Hamburg (300 beds, 80% civilians). We performed (i) a medication reconciliation to obtain information on outpatient medications and (ii) a medication review to solve drug-related-problems, e.g., drug-drug interactions. We applied (iii) the algorithm to switch medications to the hospital formulary. Results: (i) We identified 475 outpatient medications (median per patient: 4; Q25/Q75 2/7) in 100 patients consecutively admitted to hospital (median age: 71; Q25/Q75: 64/80 years). Of 475 medications, the switching algorithm could not be used since product names were missing in 23.9% and strength in 1.7%. In 3.2%, switching was not required since medication was not prescribed during the hospital stay. (ii) Drug-drug interactions were identified in 31 of 79 patients with more than one medication. (iii) Of 475 medications, 18.5% were on the hospital formulary and therefore did not need to be switched (S0), 0.2% were on a substitution-exclusion list not allowing switching (S1), 42.0% were switched to a generic medication of the hospital formulary (S2), 1.7% to a therapeutically equivalent medication (S3), 0.4% were patient-individually switched (S4), and for 8.2% a standardized/patient-individual switching was not possible (S5). Conclusions: Despite comprehensive medication reconciliation, patient- and medication-related information for switching medications to the hospital formulary was often missing. Once all the necessary information was available, standardized switching could be easily carried out according to a newly developed switching algorithm.
      pubtype: Academic Journal
      doctype:
        algorithm
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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