在初级保健机构的老年退伍军人中实施药剂师驱动的阿司匹林降低处方协议
Christy Johny Varghese1, Mike Grunske2, Michael W Nagy2
11 Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota.
与单独提供者教育相比,药剂师指导的阿司匹林降低了老年人的阿司匹林使用. 这种干预措施对动脉样硬化心血管疾病 (ASCVD) 的初级预防有效.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 最近的指导方针建议不使用阿司匹林作为老年人动脉样硬化心血管疾病 (ASCVD) 的初级预防.
- 尽管指导方针发生了变化,但阿司匹林在这个人口群体中仍然存在.
- 退伍军人卫生管理局 (VHA) 的初级保健机构为干预提供了机会.
研究的目的:
- 为了比较一个药剂师驱动的阿司匹林降低处方协议与单独的初级保健提供者 (PCP) 教育.
- 评估药剂师干预减少阿司匹林处方用于ASCVD初级预防的有效性.
主要方法:
- 在VHA医疗中心的一项前性队列研究中,涉及70岁以上的患者为初级ASCVD预防处方阿司匹林.
- 干预组接受了药剂师主导的脱处方和PCP教育;对照组仅接受了PCP教育.
- 排除标准包括来自外部来源的阿司匹林,非ASCVD指示或之前的ASCVD病史.
主要成果:
- 药剂师主导的抑郁处方组与仅教育组 (18%;P = 0.0001) 相比,达到了显著更高的阿司匹林抑郁处方率 (54%).
- 联系了65名符合标准的患者,要求他们去处方.
- 该研究针对干预组的520名患者,对照组的417名患者.
结论:
- 药剂师领导的阿司匹林脱处方协议在初级保健机构中非常有效.
- 与标准PCP教育相比,这种方法显著减少了用于ASCVD初级预防的阿司匹林处方.
- 这些发现支持将药剂师纳入指导方针护理的药物处方计划.
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