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药剂师驱动协议对两家初级保健诊所纳洛处方率的影响
Ashley Daffron1, Kelly Koon2, Nathan P Gruenke3
1Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, 12850 E. Montview Blvd, C238 Aurora, CO 80045, United States.
Preventive medicine reports
|December 20, 2023
概括
一个由药剂师领导的外展计划显著增加了初级保健中纳洛联合处方率. 这种减少危害的策略,包括患者教育和提供者建议,改善了对预防阿片类药物过量服用的CDC指南的遵守.
科学领域:
- 公共卫生 公共卫生
- 药理学 药理学是指药理学的学科.
- 临床药房 临床药房
背景情况:
- 美国疾病控制和预防中心 (CDC) 建议同时开纳洛,以减轻阿片类药物过量使用的风险.
- 尽管有建议,但许多有风险的患者没有被处方纳洛,突出了减少危害的差距.
- 需要有效的策略来增加临床实践中纳洛的联合处方.
研究的目的:
- 评估一项旨在提高纳洛联合处方率的药剂师驱动协议.
- 评估电话患者外展和电子医疗记录 (EMR) 提供者的建议对纳洛处方的影响.
主要方法:
- 在两个初级保健诊所进行了一项多中心回顾性队列研究.
- 一项干预涉及药剂师和药房实习生,他们通过电话开展纳洛教育和共同处方建议.
- 提供者建议也被整合到EMR中.
主要成果:
- 在3个月的干预后,66.3% (57/86) 的接触患者被同时处方纳洛.
- 纳洛在36名患者的电话外展期间和随后的其他12名医疗服务提供者的访问中开始使用.
- 在接受中度至高剂量的阿片类药物 (MME ≥50) 的患者中,观察到纳洛联合处方的统计学上显著增加 (前:25/64与后:43/76,p=0.043).
结论:
- 药剂师驱动的电话外展与基于EMR的提供者建议相结合,是增加纳洛联合处方的有效策略.
- 这种干预成功地改善了在初级保健机构遵守CDC关于阿片类药物过量减少危害的指南.
- 这些发现支持将这些协议整合在一起,以提高慢性疼痛管理中的患者安全.
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