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临床药师干预对急性心肌梗死住院患者30天再入院率的影响

Impact of Clinical Pharmacist Interventions on 30-Day Readmission Rate in Hospitalized Patients With Acute Myocardial Infarction.

作者信息

Gasbarro Nicole M, Eginger Kristin H, Street Connie

机构信息

University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA.

CaroMont Regional Medical Center, Gastonia, NC, USA.

出版信息

J Pharm Technol. 2015 Apr;31(2):64-68. doi: 10.1177/8755122514551756. Epub 2014 Sep 23.

Abstract

: Limited literature exists on the positive impact of pharmacists specifically on hospital readmission of patients with acute myocardial infarction (AMI). : To evaluate the overall effect of clinical pharmacist interventions on preventing hospital readmissions and improving the health of patients with AMI. Secondary objectives include identifying trends in the demographic characteristics of AMI patients, identifying potential barriers to adherence, and assessing the average time spent by a pharmacist counseling AMI patients. : This prospective, nonrandomized, single-center study was approved by the institutional review board. The hospital's 30-day AMI readmission rate prior to study initiation was used as the control group. An AMI report was generated daily to identify patients admitted to the hospital diagnosed with either non-ST or ST segment elevation myocardial infarction. The clinical pharmacist then counseled the included patient prior to discharge and provided a follow-up phone call 48 hours after discharge. The primary outcome was the all-cause 30-day readmission rate for AMI patients. : Out of 71 patients screened, 50 patients were included in the study. Only 3 of the 50 patients included were readmitted (6.0%). The prestudy rate from October 2012 to October 2013 was 11.6%, or 58 readmissions out of 498 AMI admissions. Although the study group was much smaller in size, a 6% readmission rate is encouraging and offers potential for a future intervention. : Clinical pharmacist services for AMI patients, including counseling, interventions, and a follow-up phone call after discharge, may benefit decreasing the 30-day AMI readmission rate; however, further studies are needed.

摘要

关于药剂师对急性心肌梗死(AMI)患者再次入院的积极影响,现有文献有限。

评估临床药剂师干预对预防AMI患者再次入院和改善其健康状况的总体效果。次要目标包括确定AMI患者人口统计学特征的趋势、确定依从性的潜在障碍以及评估药剂师为AMI患者提供咨询所花费的平均时间。

这项前瞻性、非随机、单中心研究已获得机构审查委员会的批准。研究开始前医院的30天AMI再入院率用作对照组。每天生成一份AMI报告,以识别入院诊断为非ST段或ST段抬高型心肌梗死的患者。然后临床药剂师在出院前为纳入的患者提供咨询,并在出院后48小时进行随访电话。主要结局是AMI患者的全因30天再入院率。

在筛选的71例患者中,50例患者纳入研究。纳入的50例患者中只有3例再次入院(6.0%)。2012年10月至2013年10月的研究前再入院率为11.6%,即498例AMI入院患者中有58例再次入院。尽管研究组规模小得多,但6%的再入院率令人鼓舞,并为未来的干预提供了潜力。

为AMI患者提供的临床药剂师服务,包括咨询、干预和出院后随访电话,可能有助于降低30天AMI再入院率;然而,还需要进一步研究。

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