Carter B L, Malone D C, Valuck R J, Barnette D J, Sintek C D, Billups S J
Department of Pharmacy Practice, School of Pharmacy, University of Colorado Health Sciences Center (UCHSC), Denver 80262, USA.
Am J Health Syst Pharm. 1998 Jan 1;55(1):62-7. doi: 10.1093/ajhp/55.1.62.
An ongoing study of the impact of ambulatory care clinical pharmacists on patient outcomes at selected Veterans Affairs medical centers (VAMCs) is described. The IMPROVE (Impact of Managed Pharmaceutical Care on Resource Utilization and Outcomes in Veterans Affairs Medical Centers) study will examine the effects of referring patients at high risk for drug-related problems to a pharmacist-managed monitoring program. Nine study sites from diverse geographic locations and small and large urban areas have been selected. Investigators visited each site to evaluate the structure of care, observe pharmacist-patient interactions, and assess the level and documentation of pharmacists' activities. A coordinating center will collect and process patient-specific data from the study sites to identify high-risk patients. It is expected that 500 intervention patients and 500 control patients from the nine VAMCs will complete all portions of the study. Intervention patients will be scheduled for medication assessments by ambulatory care pharmacists and will be monitored by pharmacists for at least 12 months. The coordinating center will track refill histories for intervention patients. Investigators will assess the activities performed by ambulatory care pharmacists to determine predictors of successful patient outcomes. The two groups will be compared with respect to change from baseline in quality of life and satisfaction with health care providers. A cost-benefit analysis will be undertaken to determine the impact of pharmaceutical care relative to total patient care costs. The main outcome results of the IMPROVE study are expected to be available in 1999. The IMPROVE project will be the first study of the impact of ambulatory care clinical pharmacists on patient outcomes.
本文描述了一项正在进行的关于门诊护理临床药剂师对选定退伍军人事务医疗中心（VAMC）患者治疗效果影响的研究。IMPROVE（退伍军人事务医疗中心药物管理护理对资源利用和治疗效果的影响）研究将考察把药物相关问题高风险患者转介至药剂师管理监测项目的效果。已从不同地理位置以及大小城市地区选取了9个研究地点。研究人员走访了每个地点，以评估护理结构、观察药剂师与患者的互动，并评估药剂师活动的水平和记录情况。一个协调中心将从研究地点收集并处理患者特定数据，以识别高风险患者。预计来自9个退伍军人事务医疗中心的500名干预患者和500名对照患者将完成研究的所有部分。干预患者将由门诊护理药剂师安排进行用药评估，并将由药剂师监测至少12个月。协调中心将跟踪干预患者的续方记录。研究人员将评估门诊护理药剂师开展的活动，以确定患者治疗成功的预测因素。将比较两组在生活质量和对医疗服务提供者满意度方面相对于基线的变化。将进行成本效益分析，以确定药物护理相对于患者总护理成本的影响。IMPROVE研究的主要结果预计将于1999年得出。IMPROVE项目将是第一项关于门诊护理临床药剂师对患者治疗效果影响的研究。
