社区药店驱动的 24 小时动态血压监测服务的开发与可行性。

Development and feasibility of a community pharmacy-driven 24-hour ambulatory blood pressure monitoring service.

出版信息

J Am Pharm Assoc (2003). 2020 Nov-Dec;60(6):e332-e340. doi: 10.1016/j.japh.2020.06.007. Epub 2020 Jul 19.

DOI:10.1016/j.japh.2020.06.007

Abstract

BACKGROUND

Although 24-hour ambulatory blood pressure monitoring (ABPM) is recommended by practice guidelines, access to ABPM is poor in the United States. Other countries have increased ABPM access by making it available in community pharmacies. It is not known if a similar approach is feasible in the United States.

OBJECTIVE

The objective of this study was to develop and evaluate the feasibility of a community pharmacy-driven ABPM service in the United States.

SETTING

Two independent community pharmacies.

PRACTICE DESCRIPTION

The ABPM service was developed through a collaboration between an academic partner and the clinical service leads of each pharmacy. Eligible patients were those referred by their provider or self-referred for white coat, masked, or sustained hypertension (HTN), symptoms of hypotension, or requiring confirmation of an initial diagnosis of HTN. The service was appointment-based, and the pharmacist sent the ABPM results and interpretation to the referring provider via facsimile.

PRACTICE INNOVATION

This is the first description of a community pharmacy-driven ABPM service in the United States.

EVALUATION

Descriptive statistics were used to summarize the data for the baseline demographics, ABPM findings, and a 9-question patient satisfaction survey.

RESULTS

A total of 52 patients with a mean (SD) age of 56.6 (16.1) years, 50% women, 75% white, and 71.2% with a prior diagnosis of HTN were enrolled. Forty-six patients (88.5%) had successful ABPM readings with the most common blood pressure phenotypes being nocturnal HTN (91.3%), nondipper (52.1%), sustained HTN (41.3%), normotensive (23.9%), and white coat HTN (19.6%). Overall, 88% of the patients strongly agreed or agreed that they were very satisfied with their experience using the ABPM service.

CONCLUSION

A community pharmacy-driven ABPM service is feasible in the United States and may be one approach to improve access to ABPM.

摘要

背景

尽管实践指南推荐进行 24 小时动态血压监测（ABPM），但在美国，获得 ABPM 的机会却很差。其他国家通过在社区药店提供 ABPM 来增加 ABPM 的可及性。目前尚不清楚在美国是否可以采用类似的方法。

目的

本研究旨在开发并评估美国社区药店驱动的 ABPM 服务的可行性。

设置

两家独立的社区药店。

实践描述

ABPM 服务是通过学术合作伙伴与每家药店的临床服务负责人之间的合作开发的。符合条件的患者是那些由其提供者转介或自行转介的白大衣、掩蔽或持续性高血压（HTN）、低血压症状或需要确认初始 HTN 诊断的患者。该服务是预约制的，药剂师通过传真将 ABPM 结果和解释发送给转介的提供者。

实践创新

这是美国第一个描述社区药店驱动的 ABPM 服务的描述。

评估

使用描述性统计数据总结了基线人口统计学、ABPM 结果和 9 个问题的患者满意度调查的数据。

结果

共纳入 52 名平均（标准差）年龄为 56.6（16.1）岁的患者，50%为女性，75%为白人，71.2%有 HTN 既往诊断。46 名患者（88.5%）的 ABPM 读数成功，最常见的血压表型为夜间 HTN（91.3%）、非杓型（52.1%）、持续性 HTN（41.3%）、正常血压（23.9%）和白大衣 HTN（19.6%）。总体而言，88%的患者强烈同意或同意他们对使用 ABPM 服务的体验非常满意。