Oderda Lynda, Holman Christine, Nichols Ben, Rupper Randall, Bair Byron, Hoffman Matthew, Hicken Bret
Pharmacotherapy Department, University of Utah College of Pharmacy, and a clinical pharmacist, Pharmacy Department, Veterans Affairs Salt Lake City Health Care System (VASLCHCS), Salt Lake City, Utah.
Consult Pharm. 2011 Apr;26(4):264-73. doi: 10.4140/TCP.n.2011.264.
To describe the development and implementation of a telephone clinic for evaluating continued effectiveness of antidementia medication therapy in patients with dementia.
Ambulatory care at the Veterans Affairs Salt Lake City Health Care System.
A pharmacist-directed, telephone dementia clinic review of patients taking dual antidementia therapy to determine whether a medication-discontinuation trial is appropriate based on caregiver global impressions.
Pharmacists review eligible patients' electronic medical records for adherence history and caregiver impressions of response to antidementia medications to determine if a discontinuation trial of antidementia medication is warranted. Pharmacists coordinate any discontinuation discussion with caregivers and medical providers and monitor patients' response to the resultant interventions via telephone.
Pharmacist involvement allows for a structured method of monitoring adherence with antidementia medications and for determining whether they continue to provide benefit.
Expected results include percentage of patients who underwent a medication-discontinuation trial, percentage of patients who did not demonstrate clinical decline after a discontinuation trial, and percentage of patients who subsequently restarted medication because of noticeable decline after the discontinuation trial.
This telephone clinic capitalizes on the expertise of clinical pharmacists and helps establish a functional collaboration between health care providers, patients, and the electronic medical record to obtain a multiperspective evaluation of the effectiveness of antidementia therapy from a patient-centric view. This systematic approach improves patient-centered care and may have favorable impacts on antidementia medication cost utilization.
描述一个用于评估痴呆患者抗痴呆药物治疗持续有效性的电话诊所的建立与实施情况。
盐湖城退伍军人事务医疗保健系统的门诊护理。
由药剂师主导，通过电话对接受双重抗痴呆治疗的患者进行痴呆症诊所评估，根据护理人员的总体印象确定是否适合进行药物停用试验。
药剂师查阅符合条件患者的电子病历，了解其用药依从性历史以及护理人员对抗痴呆药物反应的印象，以确定是否有必要进行抗痴呆药物停用试验。药剂师与护理人员和医疗服务提供者协调任何停用讨论，并通过电话监测患者对后续干预措施的反应。
药剂师的参与提供了一种结构化的方法，用于监测抗痴呆药物的依从性，并确定这些药物是否继续有效。
预期结果包括接受药物停用试验的患者百分比、停用试验后未出现临床衰退的患者百分比，以及停用试验后因明显衰退而随后重新开始用药的患者百分比。
这个电话诊所利用了临床药剂师的专业知识，有助于在医疗服务提供者、患者和电子病历之间建立有效的合作，以从患者中心的角度对抗痴呆治疗的有效性进行多视角评估。这种系统方法改善了以患者为中心的护理，并可能对抗痴呆药物成本利用产生有利影响。
