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亚利桑那州农村地区药师主导的电话药物治疗管理项目评估:对社区卫生实践的启示

Evaluation of a Pharmacist-Led Telephonic Medication Therapy Management Program in Rural Arizona: Implications for Community Health Practice.

作者信息

Axon David R, Kloster Jim, Eckert Becka, Morales Sonia, Riggs Sally, Kilungo Aminata, Ehiri John, Grieser Megan, Turner-Warren Tenneh, Aseret-Manygoats Teresa, Bingham Jennifer M, Scovis Nicole, Warholak Terri

机构信息

R. Ken Coit College of Pharmacy, University of Arizona, Tucson, AZ 85721, USA.

Mel and Enid Zuckerman College of Public Health, University of Arizona Mel, Tucson, AZ 85724, USA.

出版信息

Clin Pract. 2022 Apr 22;12(3):243-252. doi: 10.3390/clinpract12030029.

Abstract

This study evaluated a pharmacist-led telephonic Medication Therapy Management (MTM) program for rural patients in Arizona with poor access to healthcare services. A pharmacist provided telephonic MTM services to eligible adult patients living in rural Arizona communities with a diagnosis of diabetes and/or hypertension. Data were collected and summarized descriptively for demographic and health conditions, clinical values, and medication-related problems (MRPs) at the initial consultation, and follow-up data collected at 1 and 3 months. A total of 33 patients had baseline and one-month follow-up data, while 15 patients also had three-month follow-up data. At the initial consultation, the following MRPs were identified: medication adherence issues, dose-related concerns, adverse drug events (ADE), high-risk medications, and therapeutic duplications. Recommendations were made for patients to have the influenza, herpes zoster, and pneumonia vaccines; and to initiate a statin, angiotensin converting enzyme inhibitor, angiotensin receptor blocker, beta-blocker, and/or rescue inhaler. In conclusion, this study demonstrated that while pharmacists can identify and make clinical recommendations to patients, the value of these interventions is not fully realized due to recommendations not being implemented and difficulties with patient follow-up, which may have been due to the COVID-19 pandemic. Additional efforts to address these shortcomings are therefore required.

摘要

本研究评估了一项由药剂师主导的电话药物治疗管理(MTM)项目,该项目针对亚利桑那州农村地区难以获得医疗服务的患者。一名药剂师为居住在亚利桑那州农村社区、被诊断患有糖尿病和/或高血压的符合条件的成年患者提供电话MTM服务。收集并描述性总结了初始咨询时的人口统计学和健康状况、临床指标以及药物相关问题(MRP)的数据,以及在1个月和3个月时收集的随访数据。共有33名患者有基线数据和1个月的随访数据,15名患者还有3个月的随访数据。在初始咨询时,发现了以下MRP:用药依从性问题、剂量相关问题、药物不良事件(ADE)、高风险药物和治疗重复。建议患者接种流感、带状疱疹和肺炎疫苗;并开始使用他汀类药物、血管紧张素转换酶抑制剂、血管紧张素受体阻滞剂、β受体阻滞剂和/或急救吸入器。总之,本研究表明,虽然药剂师可以识别患者并给出临床建议,但由于建议未得到实施以及患者随访困难(这可能是由于新冠疫情),这些干预措施的价值并未得到充分实现。因此,需要做出更多努力来解决这些不足。

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Medication Therapy Management: Current Challenges.药物治疗管理:当前挑战
Integr Pharm Res Pract. 2020 Apr 2;9:71-81. doi: 10.2147/IPRP.S179628. eCollection 2020.
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Cost of Prescription Drug-Related Morbidity and Mortality.与处方药相关的发病率和死亡率的成本。
Ann Pharmacother. 2018 Sep;52(9):829-837. doi: 10.1177/1060028018765159. Epub 2018 Mar 26.

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