Marianne Hald Clemmensen

Resumé Introduktion Præparatskift forårsaget af forsyningsvanskeligheder udfordrer patientsikkerheden og kan føre til medicineringsfejl og hospitalsindlæggelser. Præparatskift skaber forvirring og usikkerhed blandt sundhedsprofessionelle og patienter, som ofte udtrykker bekymring ved præparatskift, især ved tilbagevendende symptomer og bivirkninger. Praktiske udfordringer som fx synkeproblemer eller ændringer i injektionsmedicin kan påvirke compliance. Sundhedsprofessionelle spiller en vigtig rolle i at sikre patientsikkerheden gennem patientuddannelse og kontinuitet i pleje. Formål Studiet formål er at undersøge patienters erfaringer med præparatskift og behovet for information og støttende initiativer ved skifte i injektionsbehandlinger, som selvadministreres i eget hjem. Metode Fire fokusgruppeinterviews blev gennemført online og fysisk med ni patienter, som har erfaring med præparatskift af subkutane injektioner. Data blev analyseret ved hjælp af en tematisk netværksanalyse. Resultater Fire hovedtemaer blev identificeret: 1) Behov for forberedelse ved skift af injektionsmedicin. 2) Tryghed ved ny injektionsmedicin 3) Informationskilde ved skift i injektionsmedicin. 4) Økonomisk perspektiv. Konklusion Patienter ønsker mundtlig information om præparatskift ved sygeplejekonsultationer, og sygehusapotekerne kan støtte ambulatorierne ved at sikre rettidig information om præparatskift. Demonstrationsenheder er vigtige for patientsikkerheden, da de giver patienterne mulighed for at øve sig i håndteringen og administrationen af et nyt præparat i patientsikre omgivelser. Medicinalleverandører opfordres til at levere disse ved licitationsprocessen. Keywords: Præparatskift i injektionsmedicin, patientperspektiv, sygeplejekonsultationer, patienttryghed, demonstrationsdevice, selvadministration, patientsikkerhed, licitationsskift.

Background and aim: Hospitalization often leads to changes in patients’ medicine which challenges a safe medication use after discharge. Medicine information helplines (MIHs) can be valuable for patients in overcoming these challenges. This study evaluates patient satisfaction with a newly established Danish hospital-based MIH for discharged patients. The MIH is operated by experienced pharmacists and a pharmacy technician, and the study explores how the service affects the patient’s concerns and perception of safety in relation to their medication, followed by an assessment of the clinical impact of MIH on patient safety. Method: A randomized controlled study design was used in the present study. The study was registered at clinicaltrials.gov with the identification number NCT03829995. Participants were randomized 1:4 (50:200) into a control- and intervention group. Participants in the control group were offered standard care and those in the intervention group were offered access to the MIH. A telephone interview performed 2–4 weeks after discharge assessed patient satisfaction with the helpline and patient’s feeling of safety in relation to medicine use (primary outcome). Data were analyzed using a Mann-Whitney U test. After case handling of each enquiry to the MIH, the cases were assessed with regard to medication-related problems (MRPs) and clinical impact of the MIH service was assessed (primary outcome). Results: A total of 250 participants were included in the study and 152 participated in the telephone interviews (33 control and 119 intervention). Thirty-seven questions were enquired by 26 participants to the MIH. Of these, 8 were requested before the telephone interviews and these patients all expressed a high satisfaction with the MIH (score 4.57 +/- 0.73 on a 5-point scale). Most patients offered access to the MIH expressed that it increased the sense of safety in relation to their medicines (79%). However, comparing the control- and intervention group with regard to patient concerns and feeling of safety in relation to medicine use no differences were found. Evaluation of the enquiries revealed at least one MRP per enquiry, and in most cases the advice given were assessed to have a high- or moderate clinical significance. Conclusion: The MIH was appreciated by the participants, indicating that the MIH could be a valuable service for discharged patients in improving the sense of safety in relation to medication and alleviating MRPs. Providing easy access for patients to medicine information may contribute to patient safe medicine use after discharge.