在初级保健环境中实施阿片类药物管理团队的影响
Shelby Kelsh1, Margaret de Voest1, Michael Stout2
1Ferris State University, Grand Rapids, MI, USA.
Hospital pharmacy
|June 26, 2024
概括
一个跨专业的阿片类药物管理团队减少了高剂量阿片类药物处方 (MME) 和增加了初级保健中的纳洛处方. 这一举措提高了患者的安全性和遵守疾病预防控制中心指导方针.
科学领域:
- 主要护理是指初级护理.
- 临床药房 临床药房
- 公共卫生 公共卫生
背景情况:
- 美国疾病预防控制中心 (CDC) 2022年关于阿片类药物处方的指导方针强调了共享决策和提供者-患者关系.
- 跨专业团队可以支持提供者和患者管理阿片类药物治疗.
- 一个初级保健部门成立了一个阿片类药物管理团队,以使处方与CDC建议保持一致.
研究的目的:
- 评估6个月来服用高剂量阿片类药物 (每天≥90MME) 的患者的吗啡毫克相当量 (MME) 的减少.
- 评估在提供者教育后纳洛处方的变化.
主要方法:
- 在30个初级保健中心进行了为期6个月的研究 (2021-2022年).
- 一个跨专业团队利用电子病历仪表板来识别需要干预的患者.
- 干预措施包括仪表板报告,提供者教育,政策传播和图表审计.
主要成果:
- 在每天≥90个MME的患者中,每日MME的中位数从140下降到120 (P<.001).
- 6个月后,纳洛的处方从37.2%增加到62.4% (P < .001).
- 在基线确定了290名每天服用慢性阿片类药物剂量≥90MME的患者.
结论:
- 阿片类药物管理团队的干预措施显著减少了MME.
- 纳洛的处方量显著增加,提高了患者的安全性.
- 该研究表明,跨专业团队在优化阿片类药物处方实践方面的有效性.
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