验证一个算法,以优先考虑患者在初级保健机构的综合药物管理
Martin A Bishop1, Hsien-Yen Chang2, Christopher Kitchen3
1Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, MD, USA.
International journal of clinical pharmacy
|July 23, 2024
概括
医疗保健索赔数据可以识别需要综合药物管理 (CMM) 的患者. 这项研究验证了基于索赔的算法来优先考虑CMM服务,显示了与临床医生评论的适度一致.
科学领域:
- 药物经济学和健康研究成果研究成果
- 医疗保健服务研究 医疗服务研究
- 临床药房实践 临床药房实践
背景情况:
- 综合药物管理 (CMM) 计划提高了药物的有效性和安全性.
- 对CMM服务的利用不足表明需要更好的患者识别方法.
- 医疗保健索赔数据对于识别CMM适合患者的有用性仍未得到充分探索.
研究的目的:
- 评估基于声明的算法的面部有效性,旨在识别可以从CMM中受益的患者.
- 为了确定医疗保健索赔数据是否可以有效地优先考虑个人进行CMM干预.
主要方法:
- 使用索赔数据,开发了患者级别的"治疗方案复杂性"和"高风险不良反应"标记.
- 将180个患者记录分类为四个CMM需要的组:非常可能,可能,不可能和非常不可能.
- 通过比较其CMM需求优先级与独立临床医生评论来评估算法性能,计算百分比一致性和kappa统计.
主要成果:
- 基于索赔的算法确定了90%的患者"很可能"需要CMM,与临床医生的评估保持一致.
- 只有5%的患者被归类为"非常不太可能"需要CMM的患者被临床医生确定为CMM.
- 在基于索赔的算法和临床医生评论之间观察到适度的互评者协议 (kappa = 0.6,p < 0.001).
结论:
- 基于索赔的药房措施显示出作为一个有效的工具来根据CMM需求对患者进行分层的承诺.
- 在在临床实践中实施这种基于声明的算法之前,建议进行进一步的验证和测试.
- 这种方法可以通过针对适当的患者群体来帮助优化CMM服务的利用.
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