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心力衰竭过渡期的药师作用评价

A Review of the Role of the Pharmacist in Heart Failure Transition of Care.

机构信息

Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA.

出版信息

Adv Ther. 2018 Mar;35(3):311-323. doi: 10.1007/s12325-018-0671-7. Epub 2018 Feb 27.

Abstract

UNLABELLED

This article reviews current literature on the role of pharmacists in the transition of care (TOC) for patients with heart failure (HF) and the impact of their contributions on therapeutic and economic outcomes. Optimizing the TOC for patients with HF from the hospital to the community/home is crucial for improving outcomes and decreasing high rates of hospital readmissions, which are associated with increased morbidity, mortality, and costs. A multidisciplinary team approach to the management of patients with HF facilitates the transition from the hospital to the ambulatory care setting, allowing for the consideration of medical, pharmacological, and lifestyle variables that impact the care of individual patients. Pharmacist participation on both inpatient and outpatient teams can provide a variety of services that have been shown to reduce hospital readmission rates and benefit patient management and treatment. These include medication reconciliation, patient education, medication dosage titration and adjustment, patient monitoring, development of disease management pathways, promotion of medication adherence, and postdischarge follow-up. In addition, as new pharmacologic treatments for HF become available, pharmacists can raise awareness of optimal drug use by maximizing education related to efficacy (e.g., adherence) and safety (e.g., potential side effects and drug interactions). Improving understanding of HF and its treatment will enable increased pharmacist involvement in the TOC that should lead to improved outcomes and reduced healthcare costs.

FUNDING

Novartis.

摘要

本文回顾了当前关于药师在心力衰竭(HF)患者过渡护理(TOC)中的作用的文献,以及他们的贡献对治疗和经济结果的影响。优化 HF 患者从医院到社区/家庭的 TOC 对于改善预后和降低高住院再入院率至关重要,因为高住院再入院率与发病率、死亡率和成本增加有关。多学科团队管理 HF 患者的方法有助于从医院过渡到门诊护理环境,从而可以考虑影响个体患者护理的医疗、药理学和生活方式变量。药剂师在住院和门诊团队中的参与可以提供各种服务,这些服务已被证明可以降低住院再入院率,并有利于患者管理和治疗。这些服务包括药物重整、患者教育、药物剂量滴定和调整、患者监测、制定疾病管理途径、促进药物依从性以及出院后随访。此外,随着新型 HF 治疗药物的出现,药剂师可以通过最大限度地提高与疗效(例如,依从性)和安全性(例如,潜在副作用和药物相互作用)相关的教育,提高对最佳药物使用的认识。加深对 HF 及其治疗的理解将使药剂师更多地参与 TOC,从而改善预后并降低医疗保健成本。

资助:诺华公司。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2834/5859692/ba85fac4875e/12325_2018_671_Fig1_HTML.jpg

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