Parajuli Daya Ram, Franzon Julie, McKinnon Ross A, Shakib Sepehr, Clark Robyn A
School of Nursing and Midwifery, Flinders University, GPO Box 2100, Adelaide, South Australia, 5001, Australia.
Flinders Centre for Innovation in Cancer, School of Medicine, Flinders University, Adelaide, South Australia, Australia.
Curr Heart Fail Rep. 2017 Apr;14(2):78-86. doi: 10.1007/s11897-017-0323-2.
This review highlights the current and emerging approaches for the role of the pharmacist for improving self-care and outcomes in heart failure management.
Pharmacists are contributing to heart failure management in a variety of settings, including hospitals, clinics, and communities. Different interventions which may be mediated by the pharmacist include drug adherence, discharge counseling, medication reconciliation, telephone follow-up, and recommendation of evidence-based medicines. Pharmacist engagement in heart failure management has demonstrated improved drug adherence, readmission rates, medication management, self-care ability, patient satisfaction, and heart failure knowledge. Some findings are mixed, especially for readmission rates. Improved medication management was reported in nearly all studies, despite significant heterogeneity in the models of care, patient populations, and study designs. This review highlights the requirement for large randomized trials with extended follow-up to confirm the impact of the role of the pharmacist in HF self-care, particularly through multidisciplinary-based interventions.
本综述重点介绍了药剂师在改善心力衰竭管理中的自我护理及治疗效果方面的现有及新兴方法。
药剂师在包括医院、诊所和社区在内的各种环境中为心力衰竭管理做出贡献。药剂师可能介导的不同干预措施包括药物依从性、出院咨询、用药核对、电话随访以及循证药物推荐。药剂师参与心力衰竭管理已证明可提高药物依从性、再入院率、用药管理、自我护理能力、患者满意度以及心力衰竭知识水平。有些结果好坏参半,尤其是再入院率方面。尽管护理模式、患者群体和研究设计存在显著异质性,但几乎所有研究都报告了用药管理得到改善。本综述强调需要进行长期随访的大型随机试验,以确认药剂师在心力衰竭自我护理中的作用影响,特别是通过基于多学科的干预措施。