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综合临床与专科药学实践模式管理多发性硬化症患者。

Integrated clinical and specialty pharmacy practice model for management of patients with multiple sclerosis.

机构信息

Rebekah L. Hanson, Pharm.D., BCPS, BCACP, is Clinical Liaison Pharmacist, Specialty Pharmacy Services, and Clinical Assistant Professor, Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago (UIC), Chicago. Mitra Habibi, Pharm.D., is Clinical Pharmacist, Department of Neurology, University of Illinois Hospital and Health Sciences System, Chicago, and Clinical Assistant Professor, College of Pharmacy, UIC. Nehrin Khamo, Pharm.D., is Clinical Staff Pharmacist, Specialty Pharmacy Services, and Clinical Instructor, Department of Pharmacy Practice, College of Pharmacy, UIC. Sherif Abdou, B.S., is Pharm.D. Candidate and Student Pharmacist, Specialty Pharmacy Services; and JoAnn Stubbings, B.S.Pharm., M.H.C.A., is Assistant Director, Specialty Pharmacy Services, and Clinical Associate Professor, Department of Pharmacy Practice, College of Pharmacy, UIC.

出版信息

Am J Health Syst Pharm. 2014 Mar 15;71(6):463-9. doi: 10.2146/ajhp130495.

Abstract

PURPOSE

An integrated clinical and specialty pharmacy practice model for the management of patients with multiple sclerosis (MS) is described.

SUMMARY

Specialty medications, such as disease-modifying therapies (DMTs) used to treat MS, are costly and typically require special administration, handling, and storage. DMTs are associated with high rates of nonadherence and may have associated safety risks. The University of Illinois Hospital and Health Sciences System developed an MS pharmacy practice model that sought to address the many challenges of coordinating care with multiple entities outside the health system. Several key features of the integrated model include a dedicated clinical pharmacist on the MS specialty team, an integrated specialty pharmacy service, direct access to the electronic medical record, and face-to-face interaction with patients. Through the active involvement of the neurology clinical pharmacist and an onsite specialty pharmacy service, targeted assessments and medication and disease education are provided to the patient before DMT initiation and maintained throughout therapy. In addition, the regular point of contact and refill coordination encourages improved compliance, appropriate medication use, ongoing safety monitoring, and improved communication with the provider for quicker interventions. This fosters increased accessibility, convenience, and patient confidence. Improving patient outcomes--the priority goal of this service model--will be assessed in future planned studies. Through this new practice model, providers are empowered to incorporate specialty medication management into transitions in care, admission and discharge quality indicators, readmissions, and other core measures.

CONCLUSION

An integrated pharmacy practice model that includes an interdisciplinary team of physicians, nurses, and pharmacists improved patient compliance with MS therapies.

摘要

目的

描述一种用于管理多发性硬化症(MS)患者的综合临床和专业药房实践模式。

摘要

治疗 MS 的疾病修正疗法(DMT)等特种药物价格昂贵,通常需要特殊的管理、处理和储存。DMT 与高不依从率相关,并且可能存在相关的安全风险。伊利诺伊大学医院和健康科学系统开发了一种 MS 药房实践模式,旨在解决协调与医疗系统之外的多个实体的护理所面临的许多挑战。综合模型的几个关键特征包括 MS 专科团队中的专职临床药剂师、综合专业药房服务、直接访问电子病历以及与患者进行面对面互动。通过神经科临床药剂师的积极参与和现场专业药房服务,在开始 DMT 治疗之前和整个治疗过程中向患者提供针对特定评估以及药物和疾病教育。此外,定期联系和药品补充协调鼓励提高依从性、适当用药、持续的安全性监测以及与提供者进行更好的沟通,以便更快地进行干预。这促进了更高的可及性、便利性和患者信心。未来计划的研究将评估提高患者结果——这是该服务模式的首要目标。通过这种新的实践模式,提供者能够将特种药物管理纳入护理过渡、入院和出院质量指标、再入院和其他核心指标中。

结论

一种整合的药房实践模式,包括医生、护士和药剂师在内的多学科团队,提高了 MS 治疗的患者依从性。

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