Peninsula Health, Frankston, Victoria, 3199, Australia.
Monash University, Clayton , Vic 3800, Australia.
Ir J Med Sci. 2021 May;190(2):819-824. doi: 10.1007/s11845-020-02343-y. Epub 2020 Aug 17.
Chronic complex diseases like atrial fibrillation have potential long-term economical and personal consequences. Shared decision-making principles may promote therapeutic compliance, satisfaction and outcomes. Pharmacists, as patient-advocates, play a key role in guiding them through complex clinical decisions about their chronic disease management and anticoagulation choices.
To evaluate the impact of pharmacist-led shared decision making on patients' satisfaction and appropriateness of their anticoagulation therapy in newly diagnosed atrial fibrillation patients.
A prospective 2-phase before and after single-centre study was conducted in an Australian hospital. Phase 1 provided usual care, and patients' satisfaction and appropriateness of their anticoagulation therapy were evaluated. Phase-2 assessed the impact on satisfaction and appropriateness of anticoagulant therapy following pharmacist-led interventions of shared decision making to promote patients' involvement.
Patients with pharmacist-led shared decision making reported higher degree of appropriateness of anticoagulation therapy and satisfaction (36% vs 92%, P < 0.001; 25% vs 68, P < 0.001), respectively. Additionally, patients who had a pharmacist input during their hospital stay received guideline-recommended anticoagulant therapy and reported satisfaction with their management was also higher in stage 2 (21% vs 65%, p < 0.001).
The study highlights pharmacist-led shared decision making in atrial fibrillation that contributes to patient satisfaction and appropriateness of therapy.
心房颤动等慢性复杂疾病具有潜在的长期经济和个人后果。共同决策原则可以促进治疗依从性、满意度和结果。药剂师作为患者的倡导者，在指导他们做出关于慢性病管理和抗凝选择的复杂临床决策方面发挥着关键作用。
评估由药剂师主导的共同决策对新诊断为心房颤动患者的满意度和抗凝治疗的适当性的影响。
在澳大利亚的一家医院进行了一项前瞻性的 2 期单中心研究。第 1 阶段提供常规护理，并评估患者的满意度和抗凝治疗的适当性。第 2 阶段评估了在药剂师主导的共同决策干预措施下促进患者参与对满意度和抗凝治疗适当性的影响。
接受药剂师主导的共同决策的患者报告了更高程度的抗凝治疗适当性和满意度（36%对 92%，P<0.001；25%对 68%，P<0.001）。此外，在住院期间接受药剂师干预的患者接受了指南推荐的抗凝治疗，并且在第 2 阶段报告对其管理的满意度也更高（21%对 65%，p<0.001）。
该研究强调了心房颤动中由药剂师主导的共同决策有助于提高患者的满意度和治疗的适当性。
