Salazar-Ospina Andrea, Amariles Pedro, Hincapié-García Jaime A, González-Avendaño Sebastián
Grupo Promoción y Prevención Farmacéutica, Facultad de Ciencias Farmacéuticas y Alimentarias, Universidad de Antioquia UdeA, Calle 70 No 52-21, Medellín, Colombia.
Grupo de Investigación en Tecnología en Regencia de Farmacia, Facultad de Ciencias Farmacéuticas y Alimentarias, Universidad de Antioquia, Calle 70 No 52-21, Medellín, Colombia.
Heliyon. 2020 Feb 11;6(2):e03333. doi: 10.1016/j.heliyon.2020.e03333. eCollection 2020 Feb.
Pharmaceutical care (PC) through the Dader method (DMet) vs. the usual care process (UCP) significantly reduced psychiatric hospitalizations and emergency service consultations during one year of follow-up of outpatients with bipolar I disorder (BD-I). To date, the effect of long-term PC on the use of health services by BD-I patients once pharmacist intervention has ended is unknown.
To determine whether the effect of PC measured by the decrease in psychiatric hospitalizations and emergency service consultations is maintained one year after pharmacist intervention ceases.
This was a retrospective analysis of patients who had previously participated in a randomized, controlled, prospective, single-center clinical trial to compare PC (intervention group) vs. UCP (control group) in BD-I patients. Data were collected from November 2012 to March 2014. The primary outcome was the use of health services measured by the number of psychiatric hospitalizations and emergency service consultations. Descriptive statistics, Student's t-test, Kaplan-Meier function, and Log-Rank test were used.
The study included 92 patients: 43 in the intervention group and 49 in the control group. Eleven psychiatric hospitalizations occurred for the intervention group and 19 for the control group. One year after pharmacist intervention ceased, there were no significant differences between the groups in psychiatric hospitalizations (p = 0.261). There were 14 emergency service consultations for the intervention group, and 24 for the control group without significant differences (p = 0.212).
PC through the DMet has no long-term effects on psychiatric hospitalizations and emergency department consultations in patients with BD-I following discontinuation of pharmacist intervention; the effect dissipates when the intervention ceases. Future studies should focus efforts on identifying factors associated with PC that explain why the outcomes derived from this intervention are not maintained in the long term.
在对双相I型障碍（BD-I）门诊患者进行为期一年的随访中，通过达德方法（DMet）提供的药学服务（PC）与常规护理流程（UCP）相比，显著减少了精神科住院治疗和急诊服务会诊次数。迄今为止，药师干预结束后，长期药学服务对BD-I患者卫生服务利用情况的影响尚不清楚。
确定药师干预停止一年后，以精神科住院治疗和急诊服务会诊次数减少来衡量的药学服务效果是否得以维持。
这是一项对先前参与随机、对照、前瞻性单中心临床试验的患者进行的回顾性分析，该试验比较了BD-I患者中PC（干预组）与UCP（对照组）的效果。数据收集时间为2012年11月至2014年3月。主要结局是通过精神科住院治疗次数和急诊服务会诊次数衡量的卫生服务利用情况。采用描述性统计、学生t检验、卡普兰-迈耶函数和对数秩检验。
该研究纳入92例患者：干预组43例，对照组49例。干预组发生11次精神科住院治疗，对照组发生19次。药师干预停止一年后，两组在精神科住院治疗方面无显著差异（p = 0.261）。干预组有14次急诊服务会诊，对照组有24次，差异无统计学意义（p = 0.212）。
在药师干预停止后，通过DMet提供的药学服务对BD-I患者的精神科住院治疗和急诊科会诊无长期影响；干预停止后效果消失。未来的研究应致力于确定与药学服务相关的因素，以解释为何该干预产生的结果不能长期维持。
