通过药剂师处方降低心房的中风风险:一项随机临床试验
Roopinder K Sandhu1,2,3,4, Miriam Fradette2, Meng Lin5
1Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.
JAMA network open
|July 24, 2024
概括
药剂师主导的口服抗凝疗 (OAC) 处方显著改善了心房患者中风风险的降低. 这种干预措施有效地弥补了OAC交付中的差距,提高了患者护理.
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.
- 公共卫生 公共卫生
背景情况:
- 在向心房动 (AF) 患者提供口服抗凝疗 (OAC) 方面存在重大差距.
- 这种缺陷使许多AF患者不必要地面临中风和相关并发症的风险.
研究的目的:
- 评估药剂师主导的OAC处方是否可以增强AF患者的中风风险降低治疗.
- 为了确定药剂师干预在改善OAC遵守和预防中风方面的有效性.
主要方法:
- 一项前性随机临床试验,涉及加拿大阿尔伯塔省27家社区药房.
- 65岁以上的AF患者和中风风险因素接受了早期或延迟的药剂师干预,以获得OAC处方.
- 在3个月的随访中,与指导方针一致的OAC使用是主要的结果指标.
主要成果:
- 与指导方针一致的OAC使用量从对照组的56.1%增加到3个月后早期干预组的92.3% (P < .001).
- 这代表了适当使用OAC的绝对增加34%,治疗所需的数量为3.
- 药剂师干预识别和治疗可采取行动的AF,包括新诊断的病例.
结论:
- 药剂师主导的OAC处方是一种高度有效的策略,用于解决AF患者中风风险降低方面的差距.
- 需要进一步进行大规模试验,以确认这种干预措施的可扩展性,可持续性,有效性和安全性.
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