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一种改进 CMS 星评分“糖尿病患者使用他汀类药物”的创新方法。

An Innovative Approach to Improving the Proposed CMS Star Rating "Statin Use in Persons with Diabetes".

机构信息

1 Washington State University, Spokane.

2 Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania.

出版信息

J Manag Care Spec Pharm. 2018 Nov;24(11):1126-1129. doi: 10.18553/jmcp.2018.24.11.1126.

Abstract

The Statin Use in Persons with Diabetes (SUPD) measure has been adopted by the Centers for Medicare and Medicaid Services as a display measure for Medicare Part C and Part D plan sponsors and is slated for inclusion within the primary star rating measure set. As such, the measure has become a focal point for quality improvement efforts by many health plans. Current pharmacy-based interventions reported in the literature involve pharmacists recommending that a patient's provider issue a prescription for a statin; studies to date have not shown that this intervention has been effective for the majority of patients with diabetes. One innovative option is pharmacist prescriptive authority of statins for patients with diabetes. In such a model, a pharmacist identifies a patient with diabetes who is not on a statin, assesses the patient for contraindications and appropriateness of therapy, and works directly with the patient to close the gap in care. This solution could lead to earlier initiation of statin therapy and reduce the burdens associated with multiple communications with the patient's primary care provider. In 2018, Idaho became the first state to allow pharmacist prescribing to close the SUPD measure, with certain regulatory safeguards in place. DISCLOSURES: No funding supported the writing of this article. The authors have nothing to disclose.

摘要

他汀类药物在糖尿病患者中的应用(SUPD)措施已被医疗保险和医疗补助服务中心(Centers for Medicare and Medicaid Services)采用,作为医疗保险 C 部分和 D 部分计划赞助商的展示措施,并计划纳入主要星级评定措施集。因此,该措施已成为许多健康计划质量改进努力的重点。目前文献中报告的基于药房的干预措施涉及药剂师建议患者的提供者为其开具他汀类药物的处方;迄今为止的研究表明,这种干预措施对大多数糖尿病患者并不有效。一种创新的选择是为糖尿病患者提供他汀类药物的药剂师处方权。在这种模式下,药剂师确定未服用他汀类药物的糖尿病患者,评估患者的禁忌症和治疗适宜性,并直接与患者合作,解决护理中的差距。这一解决方案可以更早地开始他汀类药物治疗,并减轻与患者初级保健提供者多次沟通相关的负担。2018 年,爱达荷州成为第一个允许药剂师处方以弥补 SUPD 措施的州,同时制定了某些监管保障措施。披露:本文写作没有得到任何资金支持。作者没有什么要披露的。

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