与达比加特兰坚持相关的现场水平变化和做法
Supriya Shore1, P Michael Ho2, Anne Lambert-Kerzner3
1Emory University School of Medicine, Atlanta, Georgia.
JAMA
|April 15, 2015
概括
患者选择和药剂师监测等现场级实践显著影响非膜动患者的达比加特兰坚持. 这些由药剂师主导的干预措施改善了药物坚持.
科学领域:
- 药理学 药理学是指药理学的学科.
- 医疗保健服务研究 医疗服务研究
- 内部医学 内部医学
背景情况:
- 针对特定目标的口服抗凝剂 (TSOAC),如达比加特兰,在不需要常规实验室监测的情况下,比华法林具有优势.
- 然而,了解最佳的后续策略和影响达比加坚持的现场因素仍然至关重要.
研究的目的:
- 为了评估不同医疗保健场所对达比加特兰坚持的变化.
- 确定与改善达比加特兰坚持相关的特定现场级实践.
主要方法:
- 一种混合方法的方法,结合了追溯的定量数据 (67个退伍军人卫生管理局站点,4863名患者) 和来自47名药剂师的定性数据.
- 坚持被定义为80%或以上的覆盖日数 (PDC) 的比例.
主要成果:
- 患者对达比加特兰的平均坚持率为74%,具有显著的部位水平变化 (平均几率比为1.57).
- 适当的患者选择和药剂师领导的监测与更高的坚持率相关 (RR,1.14和1.25,分别).
- 药剂师主导的教育没有显示出与遵守的统计学意义上的关联.
结论:
- 在医疗保健机构的非膜性心房动患者中,达比加特兰的坚持存在显著的变化.
- 实施特定的药剂师驱动的活动,特别是患者选择和持续监测,可以提高药物制.
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