薬剤師主導の情報技術介入 (PINCER):多センター,クラスター,ランダム化,制御試験と費用対効果分析
Anthony J Avery1, Sarah Rodgers, Judith A Cantrill
1Division of Primary Care, University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK. tony.avery@nottingham.ac.uk
Lancet (London, England)
|February 24, 2012
まとめ
薬剤師主導のIT介入 (PINCER) は,初等医療における薬剤の誤差を大幅に削減しました. このアプローチは費用対効果が高く,危険な処方箋を最小限に抑え,適切なモニタリングを確保することにより,患者の安全性を向上させました.
科学分野:
- 医療サービス 研究 医療サービス
- 患者の安全性について
- クリニック薬局 臨床薬局
背景:
- 薬剤の誤用は,プライマリケアにおいて一般的であり,患者の健康に重大なリスクをもたらす.
- 薬剤師が主導する,情報技術に基づく介入は,医薬品に関連するリスクを減らすための単純なフィードバックに対して評価されました.
研究 の 目的:
- 薬の誤差を減らすPINCER介入の有効性を評価する.
- プライマリケアにおけるPINCER介入と標準的なフィードバックを比較する.
主な方法:
- 英国の一般的な慣行を含む実用的なクラスターランダム化試験です.
- 実践は,コンピュータで生成されたフィードバックまたはPINCER介入 (フィードバック,教育的なアウトリーチ,専用のサポート) に割り当てられました.
- 6ヶ月で測定された主なアウトカムには,NSAID,ベータブロッカー,ACE阻害剤/利尿剤に関連する特定の処方誤りが含まれていました.
主要な成果:
- PINCERグループは,胃潰瘍患者のNSAIDの危険な処方率 (OR0.58) と,喘息患者のベータブロッカーの処方率 (OR0.73) を著しく低下させた.
- 高齢患者のACE阻害剤やループ利尿剤のモニタリングエラーもPINCERグループでは有意に減少した (OR0.51).
- この介入は,費用対効果の高い確率を示した.
結論:
- PINCERの介入は,一般診療における医薬品の誤差を減らすための効果的な戦略です.
- この薬剤師主導のITベースのアプローチは,改善された処方とモニタリングの実践を通じて患者の安全性を高めます.
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