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2019 - 2020年西班牙药师主导的能力 - 动机 - 机会干预措施对HIV感染者的临床影响

Clinical Impact of the Capacity-Motivation-Opportunity Pharmacist-Led Intervention in People Living with HIV in Spain, 2019-2020.

作者信息

Morillo-Verdugo Ramón, Robustillo-Cortes María de Las Aguas, Navarro-Ruiz Andrés, Sánchez-Rubio Ferrandez Javier, Fernández Espínola Sergio, Fernández-Pacheco García-Valdecasas María, Vélez-Diaz-Pallares Manuel

机构信息

Pharmacy Hospital Service, Hospital Valme, Área de Gestión Sanitaria Sur de Sevilla, Sevilla, Spain.

Pharmacy Hospital Service, Hospital Juan Ramón Jiménez, Huelva, Spain.

出版信息

J Multidiscip Healthc. 2022 May 24;15:1203-1211. doi: 10.2147/JMDH.S361305. eCollection 2022.

Abstract

BACKGROUND

People living with HIV (PLWH) have significantly enhanced their life expectancy. Consequently, age-associated comorbidities and related health conditions are increasingly found in PLWH complicating their clinical management.

OBJECTIVE

To determine the effect of the capacity-motivation-opportunity (CMO) structured pharmaceutical care intervention for improving clinical health-care results frequently associated to PLWH.

METHODS

Multicenter, prospective, pre-post intervention study evaluating the CMO pharmacist-led program in adult PLWH was conducted between September 2019 and September 2020 with six months of follow-up. The primary objective of this study was to determine differences in clinical outcomes (total cholesterol, triglycerides, HDL, blood pressure and glycosylated hemoglobin) and variation in the patient's activation measure before and after the intervention.

RESULTS

A total of 61 patients were included, 72% were men with a median age of 53 years. After the implementation of the pharmacist-driven program, the percentage of patients with high levels of total cholesterol decreased significantly (18% to 4.9%; < 0.001). Similarly, the prevalence of patients with high levels of triglycerides, HDL or with hypertension was significantly lower post intervention (13.1% to 6.6%, < 0.001; 47.5% to 6.6%, = 0.019 and 24% to 4%, = 0.009, respectively). The number of patients who achieved the highest activation level increased from 69% to 77.6% ( < 0.001).

CONCLUSION

The CMO program resulted in significantly better health outcomes during the six months following the pharmacist-led intervention as well as improved activation in PLWH.

摘要

背景

艾滋病病毒感染者(PLWH)的预期寿命已显著提高。因此,在PLWH中越来越多地发现与年龄相关的合并症及相关健康状况,这使他们的临床管理变得复杂。

目的

确定能力-动机-机会(CMO)结构化药学服务干预对改善PLWH常见临床医疗结果的效果。

方法

在2019年9月至2020年9月期间开展了一项多中心、前瞻性、干预前后对照研究,评估由药师主导的针对成年PLWH的CMO项目,并进行为期6个月的随访。本研究的主要目的是确定干预前后临床结局(总胆固醇、甘油三酯、高密度脂蛋白、血压和糖化血红蛋白)的差异以及患者激活指标的变化。

结果

共纳入61例患者,其中72%为男性,中位年龄为53岁。在实施药师主导的项目后,总胆固醇水平高的患者百分比显著下降(从18%降至4.9%;<0.001)。同样,干预后甘油三酯水平高、高密度脂蛋白水平异常或患有高血压的患者患病率也显著降低(分别从13.1%降至6.6%,<0.001;从47.5%降至6.6%,P = 0.019;从24%降至4%,P = 0.009)。达到最高激活水平的患者数量从69%增加到77.6%(<0.001)。

结论

CMO项目在药师主导的干预后的6个月内带来了显著更好的健康结局,同时提高了PLWH的激活水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ab1/9147399/8e9f1c56d249/JMDH-15-1203-g0001.jpg

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