Western University of Health Sciences College of Pharmacy, 309 E. Second St., Pomona, 91766, CA, USA.
Oregon State University College of Pharmacy Portland Campus at Oregon Health & Science University, 2730 SW Moody Ave., CL5CP, Portland, 97239, OR, USA.
BMC Pharmacol Toxicol. 2021 Apr 16;22(1):20. doi: 10.1186/s40360-021-00486-x.
A Proton Pump Inhibitor (PPI) de-escalation initiative was piloted at a Family Medicine Federally Qualified Health Center (FQHC) after a needs assessment showed that PPIs were prescribed inappropriately. The objective was to evaluate implementation of a PPI de-escalation program for an urban, underinsured patient population at a (FQHC).
Patients receiving PPI with an upcoming appointment with their primary care provider (PCP) were evaluated by a pharmacist for the appropriateness of therapy. The pharmacist administered a questionnaire to patients to assess PPI usage patterns and then evaluated for appropriate PPI therapy which included diagnoses, risk factors for gastrointestinal bleed, symptom control, and duration of PPI therapy. For consenting patients, de-escalation was implemented per pharmacist protocol.
A total of 36 patients were evaluated for appropriate PPI use, among those, 21 (58%) were eligible for de-escalation, and 19 agreed to de-escalation. Fifteen patients (15/19) had successful PPI de-escalation after 4 weeks without discomfort or symptoms which disrupted daily activities.
This pharmacist led initiative in collaboration with PCPs resulted in successful de-escalation of PPIs in an underserved primary care setting.
质子泵抑制剂 (PPI) 降级计划在一家家庭医学合格的联邦合格健康中心 (FQHC) 进行试点，此前需求评估表明 PPI 开具不当。目的是评估在城市、保险不足的患者人群中实施 PPI 降级计划在 (FQHC) 的实施情况。
接受 PPI 治疗且即将与初级保健提供者 (PCP) 预约的患者由药剂师评估治疗的适当性。药剂师对患者进行问卷调查，以评估 PPI 使用模式，然后评估适当的 PPI 治疗，包括诊断、胃肠道出血风险因素、症状控制和 PPI 治疗持续时间。对于同意的患者，根据药剂师的方案实施降级。
共有 36 名患者接受了 PPI 使用的适当性评估，其中 21 名（58%）符合降级条件，19 名同意降级。19 名患者中有 15 名（15/19）在 4 周内成功进行了 PPI 降级，没有不适或症状干扰日常生活。
这项由药剂师主导的计划与 PCP 合作，成功地在服务不足的初级保健环境中降低了 PPI 的使用。
