风险评估和风险缓解策略在政策实施后对肺高血压药物的合规性与计算机化提供者订单进入支持
Joshua Liske1, Nisha Patel1, Charles Makowski1
1Department of Pharmacy, Henry Ford Hospital, Detroit, MI, USA.
概括
实施医疗系统政策与计算机化提供者订单输入 (CPOE) 决策支持显著改善了肺高血压药物的风险评估和缓解策略 (REMS) 合规性. 这提高了患者的安全性,并简化了住院药房的分发流程.
科学领域:
- 药物经济学和卫生系统 药房
- 心脏病学和肺部医学.
- 患者安全和药物管理
背景情况:
- 肺高血压 (PH) 治疗涉及药物与风险评估和缓解战略 (REMS) 计划.
- 卫生系统的住院药房在遵守住院REMS发行标准方面面临挑战.
- 实施决策支持系统可能会提高REMS合规性.
研究的目的:
- 评估医疗系统政策的影响,包括计算机化提供者订单输入 (CPOE) 决策支持对REMS合规性.
- 评估PH药物的REMS合规性速度和及时性的改进.
- 识别与成功或延迟REMS合规相关的因素.
主要方法:
- 采用了追溯的,准实验性的研究设计.
- 在政策实施之前 (2017年8月至2019年8月) 和之后 (2019年9月至2021年8月) 的REMS合规率的比较.
- 包括接受内分泌素受体对抗剂或里奥西瓜特的成年患者,分析了150名患者 (每组75名).
主要成果:
- 预干预组的REMS遵守率从50%显著增加到后干预组的92% (P < 0.001).
- 达到REMS合规的中位时间从770分钟大幅下降到140分钟 (P = 0.031).
- 干预后组状态 (OR,16.9) 和入住PH中心 (OR,7.8) 独立地与REMS合规性相关.
结论:
- 整合CPOE决策支持的卫生系统政策有效地改善了住院患者的REMS发行合规性.
- 干预导致了显著的增长率和减少时间到REMS合规.
- 这一策略提高了患者的安全性,并优化了PH患者的药物管理.
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