关于血管压素的使用和在败血症休克中的做法,以及成本控制策略的看法
Drayton A Hammond1, Megan A Rech2, Mitchell J Daley3
1Department of Pharmacy, Rush University Medical Center, Chicago, Illinois.
Journal of the American College of Clinical Pharmacy : JACCP
|January 12, 2024
概括
药剂师在考虑其采购成本时减少了压缩剂的使用建议. 大多数机构都实施了节约成本的举措,影响了临床实践和适当的血管压素使用.
科学领域:
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
- 卫生经济学 卫生经济学
背景情况:
- 自从最新的生存败血症运动指南以来,血管压素使用的临床实践仍然没有得到评估.
- 品牌改造后的血管压素获取成本增加需要对其临床应用进行重新评估.
研究的目的:
- 评估血管压素成本控制策略.
- 评估药剂师关于适当使用压素的意见.
主要方法:
- 对重症监护和紧急医疗药剂师进行了基于场景的调查.
- 通过描述性统计,千平方,费舍尔的精确和麦克纳马的测试来分析答案.
主要成果:
- 达到了11.3%的响应率 (200/1757).
- 考虑到压素的成本,减少了与北上腺素和上腺素一起使用的建议,但增加了与类固醇一起使用的建议.
- 大多数受访者 (72%) 实施了节约成本的举措,而 Vasopressin Cost Consideration 组更有可能在没有定位的情况下,以 0.03 单位/分钟的剂量启动血压素.
结论:
- 随着血管压素的重新命名和成本增加,机构实施了减少使用和教育临床医生的举措.
- 当收购成本被考虑在内时,药剂师建议使用压素的频率较低,特别是在有争议的临床场景中.
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