临床电药学:利用协作护理模式解决贫困城市人口糖尿病管理中的护理差距
Hanlin Li1, Imama A Naqvi2, Kevin Strobino2
1Department of Pharmacy, New York-Presbyterian Hospital, New York, New York, USA.
概括
临床药房服务改善了服务不足患者的糖尿病管理,在COVID-19大流行期间,远程医疗保持了有效性. 这提高了慢性护理管理,并实现了显著的A1c降低.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 临床药房 临床药房
- 糖尿病管理 糖尿病管理
背景情况:
- 最佳的慢性护理管理受到有限的医疗保健准入和缺乏服务的人群的健康素养的阻碍.
- 临床药房服务被整合到以患者为中心的家庭模式中,主要为医疗保险/医疗补助患者提供服务.
- 通过初级保健提供者 (PCP) 向药剂师推来管理不受控制的糖尿病的现有工作流被调整.
研究的目的:
- 评估临床药房服务对糖尿病管理的影响.
- 在COVID-19大流行期间评估这些服务的远程医疗服务的有效性.
- 为了比较疫情前的面对面服务与疫情后的音频/视频远程医疗服务.
主要方法:
- 在PCP和临床药剂师之间建立了合作的实践范围.
- 没有控制的糖尿病患者被转诊进行管理,收集的数据为COVID前 (2019年1月至2020年1月) 和COVID后 (2021年4月至10月) 的数据.
- 后续评估包括过程指标 (访问量,干预类型) 和临床结果 (A1c降低).
主要成果:
- 有105名患者被转诊;COVID前的诊所95%是面对面的,COVID后转向100%的远程医疗.
- 药房访问量从COVID前的86个增加到COVID后的308个.
- 在65%的COVID前患者和69%的COVID后患者中,持续的A1c降低>0.5%.
结论:
- 通过远程医疗提供的临床药房服务对糖尿病管理产生了持续的积极影响.
- 在疫情期间,远程医疗促进了患者获取和服务量增加.
- 音频/视频远程医疗访问似乎与面对面访问在慢性疾病管理方面同样有效.
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