药剂师在慢性阻塞性肺病中的慢性疾病管理:对卫生服务利用的影响
Tatiana Makhinova1, Jeffrey A Johnson2, Jasjeet K Minhas-Sandhu2
1Faculty of Pharmacy and Pharmacutical Sciences.
Journal of managed care & specialty pharmacy
|June 5, 2023
概括
药剂师为慢性阻塞性肺病 (COPD) 患者提供综合性年度护理计划 (CACP) 并没有显著减少住院或急诊室访问. 需要进一步的研究来优化护理计划,以获得更好的COPD管理结果.
科学领域:
- 药物经济学和医疗服务研究研究 药物经济学和医疗服务研究
- 慢性疾病管理 慢性疾病管理
- 呼吸系统医学 呼吸系统医学
背景情况:
- 有限的现实世界的证据存在于药剂师领导的慢性疾病管理倡议对慢性阻塞性肺病 (COPD) 患者的有效性.
- 评估药剂师提供的综合年度护理计划 (CACP) 对COPD患者医疗资源利用的影响至关重要.
研究的目的:
- 评估与COPD相关的医疗保健资源利用在接受药剂师提供的CACP的患者中的变化,与没有CACP的患者相比.
- 分析CACP对COPD特定住院,急诊室 (ED) 访问,医生访问和肺功能测试要求的影响.
主要方法:
- 对阿尔伯塔卫生局 (2012-2015) 的行政数据的回顾性分析确定了接受CACP的COPD患者.
- 每位接受CACP的患者与两名基于年龄,性别,医疗提供者,服务日期和并发症的控制患者进行了匹配.
- 使用受控中断时间序列分析来比较CACP实施前一年和实施后一年的结果.
主要成果:
- 该研究包括74,365名COPD患者,其中28,795名 (38.7%) 接受CACP治疗.
- 虽然观察到COPD相关住院病例的减少 (每10,000名患者中有174人/月),但这一发现没有统计学意义,并未通过敏感性分析得到证实.
- 在CACP和对照组之间,没有发现与COPD相关的ED访问,全科医生访问或肺功能测试索赔的显著差异.
结论:
- 药剂师提供的年度综合护理计划 (CACPs) 并没有在一年内显著减少COPD相关的住院治疗或ED访问.
- 与对照组相比,接受CACP的患者的医生访问和肺功能测试利用率保持不变.
- 需要进一步调查,以确定如何优化护理计划,以获得更有影响力的COPD管理结果.
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