药剂师主导的心力衰竭诊断和指导方针的实施和评估指导药物疗法诊所诊所诊所诊所诊所诊所诊所诊所诊所诊所诊所诊所诊所诊所诊所诊所诊所
Angharad Thomas1, Paul Forsyth2, Ciara Griffiths3
1Lead Heart Failure Specialist Pharmacist, Cardiology, Glangwili Hospital, Hywel Dda University Health Board, Carmarthen, SA31 2AF, Wales. Angharad.thomas2@wales.nhs.uk.
International journal of clinical pharmacy
|August 27, 2024
概括
药剂师主导的心力衰竭 (HF) 诊所显著减少了诊断和专家审查时间. 这一举措还改善了农村地区HF患者的指导药物治疗 (GDMT) 优化.
科学领域:
- 心脏病学 心脏病学
- 临床药房 临床药房
- 医疗保健管理的管理
背景情况:
- 及时诊断和治疗优化对于改善心力衰竭 (HF) 患者的结果,减少死亡率和发病率至关重要.
- 虽然药剂师在药物优化中的作用已被记录,但他们参与HF诊断需要进一步探索.
- 这项研究通过检查药剂师领导的HF诊断和治疗诊所来弥补这一差距.
研究的目的:
- 开发,实施和评估由药剂师领导的心力衰竭诊所.
- 评估从转诊到诊断以及从诊断到专家审查的时间改善情况.
- 评估患者在诊断后180天内达到最佳指导药物治疗 (GDMT) 的比例.
主要方法:
- 在英国威尔士西部农村地区建立社区门诊,由经验丰富的非医疗处方药师组成.
- 基于尿素水平的紧急 (≤14天) 或常规 (≤42天) 审查的风险分层系统的实施.
- 综合性患者评估,包括体检,心电图和心声回声图,并启动GDMT治疗HF,减少喷射分数.
主要成果:
- 从转诊到诊断的中位时间从61天减少到16-19天.
- 诊断后首次专家预约的中位时间从54天减少到14天 (p < 0.0001).
- 在180天内实现最佳GDMT的患者比例从24%增加到86% (p < 0.0001).
结论:
- 药剂师领导的高频诊断和药物优化诊所显著改善了诊断及时性和专家审查.
- 这些诊所提高了农村医疗保健机构的GDMT优化率.
- 该模型展示了药剂师在综合性心力衰竭管理中的成功整合.
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