Mason J D, Colley C A
Portland Department of Veterans Affairs Medical Center (VAMC), OR 97207.
Ann Pharmacother. 1993 May;27(5):555-9. doi: 10.1177/106002809302700503.
To compare two general medicine clinics to determine the effectiveness of an ambulatory care clinical pharmacist in assisting recognition of drug therapy problems for physicians and decreasing drug therapy costs.
Controlled trial.
Two general medicine ambulatory care clinics associated with a large, tertiary-care teaching hospital.
Those with scheduled and completed appointments in the clinics during the two-week study period.
Medication profiles of patients attending clinic A (pharmacist intervention) and clinic B (no pharmacist intervention) were reviewed by the pharmacist prior to clinic appointments. Potential drug therapy problems were identified at each clinic, but interventions were performed only at clinic A. Postappointment audits determined the number of recommendations implemented at clinic A versus the number of drug therapy problems (potential interventions) recognized and addressed by clinic B physicians independently of pharmacist intervention. Potential and actual savings were extrapolated to one year from the two-week study period.
Implementation of interventions at clinic A was greater than at clinic B (p < 0.001). Drug therapy cost savings at clinic A were annualized to yield $185 per intervention. Potential cost savings of $176,724, or four times the pharmacist salary costs, is projected.
An ambulatory care pharmacist is effective in identifying drug therapy problems, resulting in significant cost savings to the institution.
比较两家普通内科诊所，以确定门诊护理临床药师在协助医生识别药物治疗问题及降低药物治疗成本方面的有效性。
对照试验。
与一家大型三级教学医院相关的两家普通内科门诊护理诊所。
在为期两周的研究期间在诊所预约并完成就诊的患者。
在诊所预约前，药师对在A诊所（有药师干预）和B诊所（无药师干预）就诊的患者的用药情况进行审查。在每个诊所识别潜在的药物治疗问题，但仅在A诊所进行干预。就诊后审计确定A诊所实施的建议数量与B诊所医生在无药师干预情况下识别和处理的药物治疗问题（潜在干预）数量。从为期两周的研究期间推算出一年的潜在和实际节省费用。
A诊所的干预实施情况优于B诊所（p < 0.001）。A诊所的药物治疗成本节省经年化计算为每次干预185美元。预计潜在成本节省为176,724美元，是药师薪资成本的四倍。
门诊护理药师在识别药物治疗问题方面有效，可为机构带来显著的成本节省。
