药师主导的综合性化疗咨询服务对外出预约依从性的影响评估。
An Evaluation of the Effect of Pharmacist-Led Comprehensive Chemotherapy Consultation Services on Outpatient Appointment Adherence.
机构信息
University of North Carolina Medical Center, Chapel Hill.
Novant Health Forsyth Medical Center, Winston-Salem, North Carolina.
出版信息
J Manag Care Spec Pharm. 2020 Jun;26(6):723-727. doi: 10.18553/jmcp.2020.26.6.723.
BACKGROUND
The North Carolina Cancer Hospital at the University of North Carolina Medical Center serves patients with a variety of malignant conditions and discharges more than 130 patients each month. Processes to improve transitions of care prompted implementation of a first-cycle, pharmacist-led chemotherapy consultation service on the inpatient oncology units. This process provides education to improve patient engagement and activation. High patient activation has been associated with better patient outcomes; poor patient activation has been associated with increased health care costs.
OBJECTIVE
To determine the effect of pharmacist-led comprehensive chemotherapy consultation services on adherence to outpatient follow-up appointments within 30 days of discharge.
METHODS
This was a single-center, retrospective chart review. This study consisted of 2 groups: adult patients who received comprehensive consultation services between April 2017 and September 2017 and a 2:1 historical group of adult control patients randomly selected from a list of patients who received their first cycle of chemotherapy during a hospital admission between April 2014 and April 2017. The primary endpoint was the effect of comprehensive consultation services on adherence to outpatient follow-up appointments within 1 month after discharge.
RESULTS
Ninety-six patients were included in this study. The percentage of appointments attended was 98.0% for the intervention group and 92.3% for the control group ( = 0.0018).
CONCLUSIONS
This study demonstrates that pharmacy consultation in the inpatient oncology setting is associated with improved adherence to outpatient appointments within 30 days of discharge. This represents the first published data on pharmacist interventions resulting in improved outpatient appointment adherence.
DISCLOSURES
Funding for this study was contributed by the Hematology/Oncology Pharmacy Association (HOPA). This publication was also supported by Grant Number UL1TR002489 from the National Center for Advancing Translational Sciences at the National Institutes of Health. Auten reports fees from PTCE and ASHP/ACCP, unrelated to this study. Clark reports consulting fees from Ellion Benson Research, unrelated to this study. The other authors do not have any conflicts of interest to report. This study was presented as a trainee poster on April 5, 2019, at the HOPA Ahead 15th Annual Conference in Fort Worth, TX.
背景
北卡罗来纳大学医学中心的北卡罗来纳癌症医院为患有各种恶性疾病的患者提供服务，每月出院患者超过 130 人。为了改善医疗服务的交接流程，该医院在住院肿瘤科病房实施了首轮由药剂师主导的化疗咨询服务。该流程提供了教育服务，以提高患者的参与度和活跃度。患者活跃度较高与较好的治疗效果相关；而患者活跃度较低则与更高的医疗成本相关。
目的
确定药剂师主导的综合性化疗咨询服务对出院后 30 天内门诊随访预约的遵从性的影响。
方法
这是一项单中心、回顾性病历审查研究。该研究包括两组患者：2017 年 4 月至 2017 年 9 月期间接受综合性咨询服务的成年患者，以及从 2014 年 4 月至 2017 年 4 月期间在住院期间接受首次化疗的成年患者中随机抽取的 2：1 比例的历史对照组患者。主要终点是综合性咨询服务对出院后 1 个月内门诊随访预约的遵从性的影响。
结果
本研究共纳入 96 例患者。干预组的预约出席率为 98.0%，对照组为 92.3%（=0.0018）。
结论
本研究表明，在住院肿瘤科环境中提供药学咨询与出院后 30 天内门诊预约的遵从性提高相关。这是关于药学干预可提高门诊预约遵从性的首次发表数据。
披露
本研究的资金由血液病/肿瘤药学协会（HOPA）提供。该出版物还得到了美国国立卫生研究院国家转化医学高级研究中心授予的 UL1TR002489 号拨款的支持。Auten 报告了与本研究无关的来自 PTCE 和 ASHP/ACCP 的酬金。Clark 报告了与本研究无关的来自 Ellion Benson Research 的咨询费。其他作者没有任何利益冲突需要披露。本研究于 2019 年 4 月 5 日在德克萨斯州沃思堡举行的 HOPA 第 15 届年度会议上以学员海报的形式进行了展示。
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