Todd Brittany A, Lamprecht Donald G, Stadler Sheila L
Kaiser Permanente Colorado, Aurora, COUniversity of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO.
Am J Health Syst Pharm. 2016 Sep 15;73(18):1442-50. doi: 10.2146/ajhp150781.
Prescribing practices within a clinical pharmacy cardiac risk service (CPCRS) and their impact on treatment outcomes in patients with atherosclerotic cardiovascular disease (ASCVD) are described.
National healthcare reforms have increased the population of insured patients and placed increased demands on physicians and other providers. Pharmacists are well trained and positioned to aid in patient care by providing expertise in medication management and patient safety that can result in pharmacotherapy optimization and cost savings. Kaiser Permanente Colorado (KPCO), a group-model health maintenance organization with about 675,000 members served by 30 medical offices throughout Colorado, has adopted a collaborative drug therapy management (CDTM) model that enables pharmacist prescribing to improve patient access, patient care, and healthcare cost-effectiveness. Within the CPCRS established by KPCO, qualified pharmacists are permitted to prescribe initial therapy, modify drug regimens, order laboratory tests, and perform follow-up activities within their professional scope of practice. The CPCRS focuses on the long-term management of patients with ASCVD. The primary goals of the CPCRS are to optimize secondary-prevention pharmacotherapy, monitor and ensure medication adherence, assist in the management of risk factors for ASCVD, provide patient education and counseling, and serve as a resource for physicians and other healthcare providers. Working under a CDTM agreement, pharmacists are authorized to prescribe therapies to minimize the risk of future ASCVD events.
The CPCRS at KPCO has demonstrated successful maintenance of a clinical pharmacy service including pharmacist prescribing under a CDTM model to manage patients with ASCVD.
描述临床药学心脏风险服务(CPCRS)中的处方实践及其对动脉粥样硬化性心血管疾病(ASCVD)患者治疗结局的影响。
国家医疗改革增加了参保患者数量,对医生和其他医疗服务提供者提出了更高要求。药剂师经过良好培训,能够通过提供药物管理和患者安全方面的专业知识来协助患者护理,从而实现药物治疗优化并节省成本。科罗拉多州凯撒医疗集团(KPCO)是一家集团模式的健康维护组织,在科罗拉多州各地设有30个医疗办公室,为约67.5万名会员提供服务。该组织采用了协作药物治疗管理(CDTM)模式,使药剂师能够开出处方,以改善患者就医机会、患者护理和医疗成本效益。在KPCO建立的CPCRS中,合格的药剂师被允许在其专业执业范围内开出处方进行初始治疗、调整药物治疗方案、安排实验室检查并开展随访活动。CPCRS专注于ASCVD患者的长期管理。CPCRS的主要目标是优化二级预防药物治疗、监测并确保药物依从性、协助管理ASCVD的危险因素、提供患者教育和咨询,并作为医生和其他医疗服务提供者的资源。在CDTM协议下工作时,药剂师被授权开出处方以尽量降低未来发生ASCVD事件的风险。
KPCO的CPCRS已成功维持了一项临床药学服务,包括在CDTM模式下由药剂师开出处方来管理ASCVD患者。