临床药学支持助理辅助华法林给药的可行性（FAST-WARD研究）

Feasibility of ASsisTed WARfarin Dosing by Clinical Pharmacy Support Assistants (FAST-WARD Study).

作者信息

Man Damen, Mabasa Vincent H

机构信息

, BSc(Pharm), ACPR, PharmD, was, at the time this study was performed, a Staff Pharmacist at Burnaby Hospital, Burnaby, British Columbia. He is now a Clinical Pharmacy Specialist-Intensive Care, Abbotsford Regional Hospital, Abbotsford, British Columbia.

, BSc(Pharm), ACPR, PharmD, is Clinical Coordinator, Burnaby Hospital, Burnaby, British Columbia.

出版信息

Can J Hosp Pharm. 2014 May;67(3):220-5. doi: 10.4212/cjhp.v67i3.1359.

DOI:10.4212/cjhp.v67i3.1359

PMID:24970942

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4071084/

Abstract

BACKGROUND

Pharmacy-managed warfarin dosing has been established at Burnaby Hospital, in Burnaby, British Columbia, for over 10 years. With increases in the number and acuity of patients enrolled, it has become challenging to maintain a successful anticoagulation program. The clinical pharmacy support assistant (CPSA) program was initiated to support the provision of clinical pharmacy services. At the time of the study, Burnaby Hospital had 2 CPSAs. It was anticipated that the pharmacy-managed inpatient warfarin dosing service might benefit from support through the CPSA program to maintain a consistent level of delivery.

OBJECTIVE

To examine the feasibility of CPSAs supporting the pharmacy-managed inpatient warfarin dosing service at Burnaby Hospital. Feasibility was based on 4 key parameters: knowledge base, accuracy of data collection, dosage recommendations, and time spent on the process.

METHODS

An observational, prospective pilot study was conducted over 3 months. The CPSAs were given appropriate education and training, and their performance was assessed to determine the feasibility of CPSA-assisted warfarin dosing. The CPSAs had to achieve a priori target scores for each of the 4 parameters in order for CPSA-assisted warfarin dosing to be considered feasible.

RESULTS

After the didactic sections, both CPSAs answered all review questions correctly. The accuracy of data collection (based on 60 patient encounters) was 98.3%. The warfarin regimens recommended by the CPSAs were similar to those recommended by the clinical pharmacists, with doses differing by a mean of 0.46 mg. For 39 (65%) of the 60 patient encounters, the dosing recommendations of CPSAs and clinical pharmacists were identical. The average time spent per patient encounter was 10.5 min.

CONCLUSION

With appropriate training and education, it is feasible for CPSAs to support the pharmacy-managed inpatient warfarin dosing program at Burnaby Hospital.

摘要

背景

在加拿大不列颠哥伦比亚省本拿比市的本拿比医院，由药房管理华法林剂量已超过10年。随着登记患者数量和病情严重程度的增加，维持一个成功的抗凝项目变得具有挑战性。启动了临床药学支持助理（CPSA）项目以支持临床药学服务的提供。在研究之时，本拿比医院有2名CPSA。预计药房管理的住院患者华法林剂量服务可能会从CPSA项目的支持中受益，以维持一致的服务水平。

目的

探讨CPSA支持本拿比医院药房管理的住院患者华法林剂量服务的可行性。可行性基于4个关键参数：知识库、数据收集的准确性、剂量建议以及该过程所花费的时间。

方法

进行了一项为期3个月的观察性前瞻性试点研究。对CPSA进行了适当的教育和培训，并评估他们的表现以确定CPSA辅助华法林剂量的可行性。为了使CPSA辅助华法林剂量被认为可行，CPSA必须在4个参数中的每一个上达到预先设定的目标分数。

结果

在理论教学部分之后，两名CPSA都正确回答了所有复习问题。数据收集的准确性（基于60次患者接触）为98.3%。CPSA推荐的华法林治疗方案与临床药师推荐的相似，剂量平均相差0.46毫克。在60次患者接触中的39次（65%），CPSA和临床药师的剂量建议相同。每次患者接触平均花费的时间为10.5分钟。