在接受血液透析的患者中处方药物:一项前性受控质量改善研究
Émilie Bortolussi-Courval1, Tiina Podymow2, Marisa Battistella3
1Division of Experimental Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
Kidney medicine
|April 17, 2024
概括
临床决策支持软件在透析患者中显著增加了潜在不合适药物 (PIM) 的处方. 这种干预,结合患者教育,提供了一个可扩展的解决方案,以减少这种脆弱人群中的药物危害.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 药理学 药理学是指药理学的学科.
- 医疗信息学 医疗信息学
背景情况:
- 透析患者经常服用多种药物 (多种药物),增加了可能不适合药物的药物损害风险 (PIMs).
- 停止处方,即停止或减少药物的过程,是减轻这种风险的策略,但可能是复杂的.
- 临床决策支持 (CDS) 工具在促进透析患者减缓处方的有效性尚不清楚.
研究的目的:
- 评估MedSafer CDS软件在治疗透析患者中增加抑郁症的有效性.
- 评估MedSafer与患者教育材料相结合对PIM减少的影响.
主要方法:
- 在两个门诊透析病房中进行了一项前性,受控的质量改善研究.
- 干预部门利用MedSafer在药物审查期间识别PIM,向科医生提供报告和向患者提供教育小册子 (EMPOWER).
- 对照单位在没有CDS干预的情况下得到了通常的护理.
主要成果:
- 与对照组 (3.1%) 相比,干预组 (39.7%) 的患者中,至少有一次PIM被处方的比例显著高于对照组 (3.1%).
- 这意味着绝对风险差异为36.6% (P < 0.0001),治疗所需数为3.
- 二次结局结果显示,干预组中处方药和PIM的平均数量减少.
结论:
- 除了患者教育之外,MedSafer CDS工具是有效的,潜在的可扩展干预措施,用于在透析患者群体中解决PIM.
- 需要进一步的研究,包括随机对照试验,以证实这些发现并评估长期结果.
- 这种方法有望提高药物安全性,减少透析治疗患者的不良药物事件.
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