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用于口服抗凝管理的数字仪表盘:一项文献综述

Digital dashboards for oral anticoagulation management: a literature scoping review.

作者信息

Wilson Aaron S, Triller Darren M, Allen Arthur, Burnett Allison, Gouveia-Pisano Julie Ann, Brenner Allison, Pritchard Barbara, Medico Charles, Vazquez Sara R, Witt Dan M, Barnes Geoffrey D

机构信息

University of Utah College of Pharmacy, Salt Lake City, UT, 84112, USA.

Anticoagulation Forum, 17 Lincoln St, Suite 2B, Newton, MA, 02461, USA.

出版信息

J Thromb Thrombolysis. 2023 Nov;56(4):568-577. doi: 10.1007/s11239-023-02880-0. Epub 2023 Aug 18.

Abstract

This scoping review summarizes the extent and characteristics of the published literature describing digital population management dashboards implemented to improve the quality of anticoagulant management. A standardized search protocol was executed to identify relevant manuscripts published between January 1, 2015 and May 31, 2022. The resulting records were systematically evaluated by multiple blinded reviewers and the findings from selected papers were evaluated and summarized. Twelve manuscripts were identified, originating from 5 organizations within the US and 2 from other countries. The majority (75%) described implementation in the outpatient setting. The identified papers described a variety of positive results of dashboard use, including a 24.5% reduction of questionable direct oral anticoagulant dosing in one organization, a 33.3% relative improvement in no-show appointments in an ambulatory care clinic, and a 75% improvement in intervention efficiency. One medical center achieved a 98.4% risk-appropriate venous thromboembolism risk prophylaxis prescribing rate and 40.6% reduction in anticoagulation-related adverse event rates. The manuscripts primarily described retrospective findings from single-center dashboard implementation experiences. Digital dashboards have been successfully implemented to support the anticoagulation of acute and ambulatory patients and available manuscripts suggest a positive impact on care-related processes and relevant patient outcomes. Prospective studies are needed to better characterize the implementation and impact of dashboards for anticoagulation management. Published reports suggest that digital dashboards may improve the quality, safety, and efficiency of anticoagulation management. Additional research is needed to validate these findings and to understand how best to implement these tools.

摘要

本综述总结了已发表文献中描述为提高抗凝管理质量而实施的数字人群管理仪表盘的范围和特征。执行了标准化搜索协议,以识别2015年1月1日至2022年5月31日期间发表的相关手稿。由此产生的记录由多名盲审人员进行系统评估,并对所选论文的结果进行评估和总结。共识别出12篇手稿,来自美国的5个组织和其他国家的2个组织。大多数(75%)描述了在门诊环境中的实施情况。已识别的论文描述了仪表盘使用的各种积极结果,包括一个组织中可疑直接口服抗凝剂剂量减少24.5%,一家门诊护理诊所未就诊预约相对改善33.3%,干预效率提高75%。一家医疗中心实现了98.4%的风险适宜的静脉血栓栓塞预防处方率,抗凝相关不良事件率降低40.6%。这些手稿主要描述了单中心仪表盘实施经验的回顾性结果。数字仪表盘已成功实施,以支持急性和门诊患者的抗凝治疗,现有手稿表明其对护理相关流程和相关患者结局有积极影响。需要进行前瞻性研究,以更好地描述抗凝管理仪表盘的实施情况和影响。已发表的报告表明,数字仪表盘可能会提高抗凝管理的质量、安全性和效率。需要更多研究来验证这些发现,并了解如何最好地实施这些工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37d0/10550856/453bba79743b/11239_2023_2880_Fig1_HTML.jpg

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