通过医疗复杂性的儿童的协作实践进行药物管理:一个潜在的案例系列
Jena Quinn1, Heather Monk Bodenstab1,2, Emily Wo1
1Perfecting Peds (JQ, HMB, EW), Haddon Heights, NJ.
概括
药剂师改善了特殊医疗需求儿童的药物管理,减少了药物问题和成本. 这种协作方法减少了这些复杂患者的再入院和药物负担.
科学领域:
- 药物治疗 药物治疗
- 儿科长期护理 儿科长期护理
- 医疗保健服务研究 医疗服务研究
背景情况:
- 对于有特殊医疗需求和医疗复杂性的儿童和青少年 (CYSHCN-CMC) 的药物管理对提供者,家庭和患者提出了重大挑战.
- 有效的护理协调,特别是药物治疗,对于改善健康结果和减少这一群体的医疗保健使用至关重要.
研究的目的:
- 描述在儿科长期护理机构 (pLTCF) 内的临床药物治疗实践的实施.
- 详细说明通过协作实践协议 (CPA) 指导的综合药物管理 (CMM) 标准操作程序的应用.
- 评估药剂师领导的CMM对药物治疗问题 (DTP),药物负担,医疗保健成本和CYSHCN-CMC.医院再入院的影响.
主要方法:
- 在9个月的时间里,采用了前性的案例系列设计.
- 102名被认定为CYSHCN-CMC的患者在PLTCF参加了这一质量改进项目.
- 药剂师利用CPA进行CMM,识别和解决DTP,并评估药物治疗方案.
主要成果:
- 药剂师发现,预防或解决了1355个DTP (平均每位患者13个),使每位患者的平均药物数量从23个减少到20个.
- 观察到显著的成本节约和避免,总计每月44,304美元的直接成本节约和每月48,835美元的成本避免.
- 这项干预措施导致医院再入院减少了44%,避免了28次急救诊所/入院,以及61次诊所/急诊诊所. 药剂师的建议被接受的比例为98%.
结论:
- 在CYSHCN-CMC中实施CMM的CPA有效降低了药物负担,并解决/预防了不良药物事件.
- 协作药物治疗实践导致了与医疗保健相关的成本和医院再入院的大幅降低.
- 该模型得到了很好的接受,并由pLTCF提供商协同实施,证明了其可行性和价值.
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