Gauen S E, Lee N L
Drug Information Services, Kaiser Permanente Northwest Region, Clackamas, OR, USA.
Am J Health Syst Pharm. 1995 Feb 1;52(3):294-6. doi: 10.1093/ajhp/52.3.294.
A smoking-cessation program at a managed health care organization and the involvement of pharmacists are described. Kaiser Permanente Northwest Region is a prepaid group-practice managed health care organization serving more than 380,000 members in Oregon and southwest Washington. A multidepartmental team at Northwest Region designed and implemented a stepped-care approach to smoking cessation in March 1992. The program progresses from advising and helping patients to quit on their own to enrolling patients in a behavioral-modification course to referring them to nicotine-replacement therapy to be given concurrently with the behavioral modification. The program was established with the help of pharmacists, and pharmacists are deeply involved in its operation. They work closely with each patient, the health educator instructing the patient, and the prescribing physician. Pharmacists attend 5 of the 10 behavioral modification/nicotine-replacement course sessions and take responsibility for enrollees throughout the program. Pharmacists prescribe and monitor nicotine-replacement therapy by protocol. They also monitor each patient for the dose-response effect, adverse drug reactions, drug interactions, concurrent medical conditions, and progress and outcome. The physician is informed about any important changes in the patient's status. In 1992, more than 80 courses were held with nearly 1000 participants, and rates of long-term abstinence achieved compare favorably with literature rates for community-based group smoking-cessation programs. Satisfaction of patients, pharmacists, and physicians with the program has been high. Pharmacists at a managed health care organization participate in a smoking-cessation program by helping with behavioral modification, educating patients about nicotine-replacement therapy, and prescribing and monitoring therapy by protocol.
描述了一家管理式医疗保健机构的戒烟计划以及药剂师的参与情况。凯撒永久医疗集团西北地区是一家预付费团体医疗管理式医疗保健机构，为俄勒冈州和华盛顿州西南部的38万多名会员提供服务。1992年3月，西北地区的一个多部门团队设计并实施了一种逐步护理的戒烟方法。该计划从建议并帮助患者自行戒烟，发展到让患者参加行为矫正课程，再到将他们转介至尼古丁替代疗法并与行为矫正同时进行。该计划是在药剂师的帮助下建立的，药剂师也深度参与其运作。他们与每位患者、指导患者的健康教育工作者以及开处方的医生密切合作。药剂师参加10节行为矫正/尼古丁替代课程中的5节，并在整个计划中负责登记入组者。药剂师按照方案开具和监测尼古丁替代疗法。他们还监测每位患者的剂量反应效果、药物不良反应、药物相互作用、并发疾病以及进展和结果。医生会被告知患者状况的任何重要变化。1992年，举办了80多场课程，有近1000名参与者，长期戒烟率与基于社区的团体戒烟计划的文献报道率相比颇具优势。患者、药剂师和医生对该计划的满意度很高。一家管理式医疗保健机构的药剂师通过帮助进行行为矫正、对患者进行尼古丁替代疗法教育以及按照方案开具和监测疗法来参与戒烟计划。
