药剂师主导教育对肥胖患者适当的预防性埃诺沙巴林剂量的影响
Brianna R Kempema Nelson1, Carly L Wehner1, Irina V Haller2
1Department of Inpatient Pharmacy, Essentia Health, Fargo, ND, USA.
Journal of pharmacy practice
|August 14, 2023
概括
药剂师教育没有改变肥胖患者住院患者的埃诺沙巴林剂量. 该研究没有发现干预后每天两次与每天一次的埃诺沙巴林剂量有显著差异.
科学领域:
- 心血管医学 心血管医学
- 药理学 药理学是指药理学的学科.
- 卫生系统科学 卫生系统科学
背景情况:
- 静脉血栓塞栓症 (VTE) 是住院中年成人的一大风险.
- 预防性抗凝剂,如埃诺沙巴林,对于预防VTE至关重要.
- 肥胖 (BMI ≥40 kg/m2) 是VTE的一个危险因素.
研究的目的:
- 评估药剂师领导的教育对埃诺沙巴林剂量策略的影响.
- 评估肥胖患者每天两次服用40毫克埃诺沙的变化,而不是每天一次服用.
- 为了确定教育干预措施是否能提高对VTE预防指南的遵守.
主要方法:
- 在Essentia Health - Fargo采用了一种病例控制研究设计.
- 在药剂师教育之前和之后,分析了急性护理患者的电子健康记录.
- 纳入标准:入院患者≥18岁,需要沙巴林预防,BMI≥40kg/m2;排除:COVID-19,最近出血.
主要成果:
- 在教育后,每天两次服用40毫克埃诺沙的几率比为0.99 (95% CI:0.96,1.02).
- 在对照组中,9/15 (60%) 患者每天服用两次剂量;在病例组中,34/70 (48.6%) 患者每天服用两次剂量.
- 在教育干预后,在剂量频率上没有观察到统计学意义上的差异.
结论:
- 药剂师主导的教育举措并没有改变肥胖住院患者每天服用40毫克埃诺沙巴林一次或两次的处方模式.
- 尽管进行了教育干预,但目前在这个人群中对埃诺沙巴林的VTE预防实践仍然是一致的.
- 可能需要进一步的策略来优化高风险患者群体的VTE预防剂量.
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