目的评估临床药师通过进行用药教育、解答抗凝用药咨询等,参与肺栓塞患者抗凝治疗管理的效果。方法以2015年3月至2017年4月于北京朝阳医院呼吸科住院的肺栓塞患者共计204例为研究对象,比较药师教育组(干预组)与其他未接受药师教育组(对...目的评估临床药师通过进行用药教育、解答抗凝用药咨询等,参与肺栓塞患者抗凝治疗管理的效果。方法以2015年3月至2017年4月于北京朝阳医院呼吸科住院的肺栓塞患者共计204例为研究对象,比较药师教育组(干预组)与其他未接受药师教育组(对照组)INR在目标范围时间的百分比(the percentage of INRs within the therapeutic range,TTR)、INR在扩大范围内时间百分比(the percentage of INRs within the expanded range,TER)、INR监测间隔时间、出血事件、再次住院率及急诊就诊率。结果干预组的TTR和TER分别为(70.89±26.02)%和(87.71±20.01)%,INR达标率显著高于对照组的(47.79±22.31)%和(71.23±21.47)%(P=0.000);干预组的INR监测间隔时间为(27.48±12.81)d,较对照组(43.35±13.65)d有显著缩短(P=0.000)。对照组及干预组患者的总出血事件(41.96%vs 29.35%,P=0.062)、严重出血事件(3.57%vs 2.17%,P=0.864)和轻微出血事件(38.39%vs 27.17%,P=0.091),差异均无统计学意义。干预组患者院外的急诊就诊次数显著低于对照组(9.82%vs 1.09%,P=0.008),两组患者再次入院率无明显差异(8.04%vs2.17%,P=0.125)。结论临床药师参与肺栓塞患者抗凝治疗管理可帮助患者更规律地监测INR,提高INR达标率,减少出院后的急诊就诊频次。展开更多
化疗相关性恶心和呕吐(chemotherapy induced nausea and vomiting,CINV)是肿瘤药物治疗中最令患者恐惧和常见的不良反应^([1])。据统计,90%以上接受高致吐化疗的患者会出现恶心呕吐症状^([2])。严重的恶心呕吐易造成脱水、代谢紊乱、...化疗相关性恶心和呕吐(chemotherapy induced nausea and vomiting,CINV)是肿瘤药物治疗中最令患者恐惧和常见的不良反应^([1])。据统计,90%以上接受高致吐化疗的患者会出现恶心呕吐症状^([2])。严重的恶心呕吐易造成脱水、代谢紊乱、营养缺乏、焦虑、畏惧化疗等后果,是肿瘤患者生活质量下降和抗肿瘤治疗中断或失败的重要原因^([3-5])[3-5]。展开更多
Objective： To assess whether adherence to amiodarone monitoring differed pre- and post-amiodarone restriction template and implementation of the pharmacist-managed clinic. Design： This was a retrospective chart revi...Objective： To assess whether adherence to amiodarone monitoring differed pre- and post-amiodarone restriction template and implementation of the pharmacist-managed clinic. Design： This was a retrospective chart review study. Setting： A large, academically-affiliated Veteran Affairs Healthcare System providing primary and tertiary care. Patients： 580 patients were identified as having an active prescription for amiodarone for at least 60 days from January l, 2009 to August 31, 2013 and receiving primary care at the VAAHS （Veterans Affairs Ann Arbor Healthcare System）. Results： Nearly all patients had TSH and LFTs at baseline regardless of study group. Significant associations between baseline rates for CXR, ECG, PFT, and opbthalmologic exams were found, with higher rates in the clinic and template arms compared to usual care. Similar patterns for all monitoring outcome rates were also found for both the 6- and 12-month measures. Conclusions： Patients on amiodarone who are followed by a pharmacist-managed clinic or where a restricted ordering template was used had increased compliance with amiodarone monitoring guidelines compared to usual care. Use of a restricted template may be a reasonable option in place of a pharmacist-managed service.展开更多
文摘目的评估临床药师通过进行用药教育、解答抗凝用药咨询等,参与肺栓塞患者抗凝治疗管理的效果。方法以2015年3月至2017年4月于北京朝阳医院呼吸科住院的肺栓塞患者共计204例为研究对象,比较药师教育组(干预组)与其他未接受药师教育组(对照组)INR在目标范围时间的百分比(the percentage of INRs within the therapeutic range,TTR)、INR在扩大范围内时间百分比(the percentage of INRs within the expanded range,TER)、INR监测间隔时间、出血事件、再次住院率及急诊就诊率。结果干预组的TTR和TER分别为(70.89±26.02)%和(87.71±20.01)%,INR达标率显著高于对照组的(47.79±22.31)%和(71.23±21.47)%(P=0.000);干预组的INR监测间隔时间为(27.48±12.81)d,较对照组(43.35±13.65)d有显著缩短(P=0.000)。对照组及干预组患者的总出血事件(41.96%vs 29.35%,P=0.062)、严重出血事件(3.57%vs 2.17%,P=0.864)和轻微出血事件(38.39%vs 27.17%,P=0.091),差异均无统计学意义。干预组患者院外的急诊就诊次数显著低于对照组(9.82%vs 1.09%,P=0.008),两组患者再次入院率无明显差异(8.04%vs2.17%,P=0.125)。结论临床药师参与肺栓塞患者抗凝治疗管理可帮助患者更规律地监测INR,提高INR达标率,减少出院后的急诊就诊频次。
文摘化疗相关性恶心和呕吐(chemotherapy induced nausea and vomiting,CINV)是肿瘤药物治疗中最令患者恐惧和常见的不良反应^([1])。据统计,90%以上接受高致吐化疗的患者会出现恶心呕吐症状^([2])。严重的恶心呕吐易造成脱水、代谢紊乱、营养缺乏、焦虑、畏惧化疗等后果,是肿瘤患者生活质量下降和抗肿瘤治疗中断或失败的重要原因^([3-5])[3-5]。
文摘Objective： To assess whether adherence to amiodarone monitoring differed pre- and post-amiodarone restriction template and implementation of the pharmacist-managed clinic. Design： This was a retrospective chart review study. Setting： A large, academically-affiliated Veteran Affairs Healthcare System providing primary and tertiary care. Patients： 580 patients were identified as having an active prescription for amiodarone for at least 60 days from January l, 2009 to August 31, 2013 and receiving primary care at the VAAHS （Veterans Affairs Ann Arbor Healthcare System）. Results： Nearly all patients had TSH and LFTs at baseline regardless of study group. Significant associations between baseline rates for CXR, ECG, PFT, and opbthalmologic exams were found, with higher rates in the clinic and template arms compared to usual care. Similar patterns for all monitoring outcome rates were also found for both the 6- and 12-month measures. Conclusions： Patients on amiodarone who are followed by a pharmacist-managed clinic or where a restricted ordering template was used had increased compliance with amiodarone monitoring guidelines compared to usual care. Use of a restricted template may be a reasonable option in place of a pharmacist-managed service.
