Lee Audrey J, Boro Maureen S, Knapp Katherine K, Meier Joy L, Korman Nancy E
School of Pharmacy and Health Sciences, University of the Pacific (UOP), USA.
Am J Health Syst Pharm. 2002 Nov 1;59(21):2070-7. doi: 10.1093/ajhp/59.21.2070.
Pharmacist recommendations and their clinical and economic outcomes in a Veterans Affairs (VA) medical center were studied. The first 600 pharmacist recommendations that met study criteria were evaluated for type and frequency, rate of acceptance by physicians, potential benefit or harm, and economic consequences. The study site included inpatient and outpatient settings and a skilled-nursing facility. The most frequent types of pharmacist recommendations involved adjusting the dosage or frequency of administration and discontinuing a drug that was not indicated for the patient's medical problem. The rate of acceptance of the recommendations was 92%. The recommendations led to improved clinical outcomes in over 30% of cases in each setting and no change in over 40% of cases in each setting. Evaluators determined that patient harm was avoided by the recommendations in 90% of cases; patient harm was caused in less than 1% of cases. The overall mean cost avoidance per recommendation was $700, and the mean total cost avoidance for all 600 recommendations was $420,155. Pharmacist recommendations improved clinical outcomes and saved money at a VA medical center.
对一家退伍军人事务（VA）医疗中心的药剂师建议及其临床和经济结果进行了研究。对符合研究标准的前600条药剂师建议进行了类型和频率、医生接受率、潜在益处或危害以及经济后果的评估。研究地点包括住院和门诊环境以及一家熟练护理机构。药剂师建议最常见的类型包括调整给药剂量或频率以及停用针对患者医疗问题无适应证的药物。建议的接受率为92%。这些建议在每种环境中超过30%的病例中带来了临床结果改善，在每种环境中超过40%的病例中没有变化。评估人员确定，90%的病例中建议避免了患者伤害；不到1%的病例中造成了患者伤害。每条建议的总体平均成本避免为700美元，所有600条建议的平均总成本避免为420,155美元。药剂师建议改善了一家VA医疗中心的临床结果并节省了资金。
