在长期护理中治疗心房的老年人的药剂师主导干预 (PIVOTALL研究):一个随机的试点和可行性研究
Leona A Ritchie1,2,3, Peter E Penson4,5, Asangaedem Akpan6,7
1Liverpool Centre for Cardiovascular Science, William Henry Duncan Building, University of Liverpool, Liverpool, L7 8TX, UK. leona.ritchie@liverpool.ac.uk.
BMC geriatrics
|January 16, 2024
概括
药剂师主导的药物审查在护理院使用心脏动更好护理 (ABC) 途径是可行的. 然而,由于个性化风险/益处评估,遵循指南推的治疗仍然很低.
科学领域:
- 老年医学 老年医学
- 心脏病学 心脏病学
- 制药科学 制药科学
背景情况:
- 患有心房动 (AF) 的养老院住户面临不良事件的高风险.
- 心房动更好的护理 (ABC) 途径是集成AF护理的黄金标准.
- 药剂师可以在实施ABC途径方面发挥关键作用.
研究的目的:
- 根据ABC路径,评估药剂师主导的护理院居民药物优化可行性.
- 为了比较药剂师主导的护理与在这个人群中对AF管理的通常护理.
主要方法:
- 进行了个别随机的,前性的试点和可行性研究.
- 患有AF的老年居民 (≥65岁) 被随机分配到ABC路径优化护理或常规护理.
- 通过招聘和保留率来衡量可行性;次要结果包括药物推和GP实施.
主要成果:
- 招募了21名住院人员,其中11人被随机分配给药剂师主导的护理.
- 对所有三种ABC途径组件的遵守率都很低 (3/11),但对于"A" (避免中风) 和"B" (更好的症状管理) 比"C" (并发症管理) 高.
- 药剂师的建议导致整体ABC遵守的变化很小,由于伴随疾病,一些建议被认为不合适.
结论:
- 实施ABC路径框架用于医药师在养老院的药物审查是可行的.
- 大多数居民的药物已经被优化,并且对指导方针的低遵守通常是基于净风险-益处的临床决策的结果.
- 需要进一步的研究来优化这群脆弱人群的AF护理.
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