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PGY2门诊护理药房住院医师进行的临床层面人群健康干预,以优化自保雇主健康计划人群的药物管理

Clinic-Level Population Health Intervention by PGY2 Ambulatory Care Pharmacy Residents to Optimize Medication Management in a Self-Insured Employer Health Plan Population.

作者信息

Vande Griend Joseph, Fixen Danielle R, Fixen Cy W, Zupec Jason, Saseen Joseph J

机构信息

1 Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy, Aurora, CO, USA.

2 Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA.

出版信息

J Pharm Pract. 2018 Feb;31(1):52-57. doi: 10.1177/0897190017698057. Epub 2017 Mar 14.

DOI:10.1177/0897190017698057
PMID:29278980
Abstract

BACKGROUND

Postgraduate year 2 ambulatory care pharmacy residents (PGY2 residents) may be able to improve healthcare quality by providing clinical pharmacy services provided to self-insured employer health plan patients. The objectives of this study are to describe this care delivery in a family medicine clinic, and to identify patients most likely to benefit from the service.

METHODS

From October 1, 2014 till June 30, 2015, comprehensive medication review was completed by PGY2 residents for patients insured by CU Anthem at the University of Colorado Westminster Family Medicine. For patients with medication-related problems (MRPs), a note was sent to the provider before the patient visit. Patient characteristics were compared in those who received a clinical pharmacy note with those who did not.

RESULTS

Sixty-eight MRPs were identified in 39 notes; 40 (58.8%) recommendations were implemented. The following Clinical Pharmacy Priority (CP2) score criteria were identified more frequently in patients with MRPs: age ≥65 years, diagnosis of diabetes, hypertension, chronic obstructive pulmonary disease, cardiovascular disease, blood pressure ≥140/90, hemoglobin A >7.9%, and ≥6 items on the medication list.

CONCLUSION

PGY2 residents identified and resolved numerous clinically relevant MRPs. Patient-specific criteria can be utilized to target self-insured employer health plan patients who are likely to have clinically relevant MRPs.

摘要

背景

二年级门诊护理药房住院医师(PGY2住院医师)或许能够通过为参加自保雇主健康计划的患者提供临床药学服务来提高医疗质量。本研究的目的是描述在一家家庭医学诊所中的这种护理服务,并确定最有可能从该服务中受益的患者。

方法

从2014年10月1日至2015年6月30日,PGY2住院医师对科罗拉多大学威斯敏斯特家庭医学中心由CU Anthem承保的患者进行了全面用药评估。对于有用药相关问题(MRP)的患者,在患者就诊前向其医疗服务提供者发送了一份说明。将收到临床药学说明的患者与未收到的患者的特征进行了比较。

结果

在39份说明中识别出68个MRP;40项(58.8%)建议得到了落实。在有MRP的患者中更频繁地发现了以下临床药学优先级(CP2)评分标准:年龄≥65岁、患有糖尿病、高血压、慢性阻塞性肺疾病、心血管疾病、血压≥140/90、糖化血红蛋白>7.9%以及用药清单上有≥6项药物。

结论

PGY2住院医师识别并解决了众多临床相关的MRP。可以利用患者特异性标准来针对可能存在临床相关MRP的参加自保雇主健康计划的患者。

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