奥兰多退伍军人事务分层工具用于阿片类药物风险缓解 (STORM) 非常高风险跨学科团队审查:简要报告
Journal of the American Pharmacists Association : JAPhA
|September 14, 2024
概括
在跨学科团队审查后,面临阿片类事件高风险的退伍军人出现了阿片类药物剂量显著降低和物质使用障碍治疗增加. 这种方法提高了患者的安全性和降低风险.
科学领域:
- 临床药房 临床药房
- 医疗保健服务研究 医疗服务研究
- 阿片类药物使用障碍治疗治疗
背景情况:
- 与普通人群相比,退伍军人事务 (VA) 患者患精神疾病,慢性疼痛和物质使用障碍 (SUD) 的患病率更高.
- 这些情况会增加与阿片类药物相关的不良事件的风险.
- 美国退伍军人部实施了阿片类药物风险减缓分层工具 (STORM),并对高风险患者进行了跨学科团队 (IDT) 审查.
研究的目的:
- 评估奥兰多退伍军人事务医疗保健系统 (OVAHCS) 的STORM工具确定为非常高风险的患者的IDT审查的实施和流程.
- 评估IDT审查对患者结果和风险减轻策略的影响.
主要方法:
- 在2018年1月至9月期间进行STORM IDT审查的退伍军人的回顾性观察图表审查.
- 对吗啡等效每日剂量 (MEDD),纳洛,非阿片类止痛药,SUD药物和类药物的变化进行分析.
- 评估与临床服务的接触,包括心理健康,SUD和疼痛诊所,以及在IDT审查之前和之后的过量服用或自杀企图的比例.
主要成果:
- 平均MEDD从基线下降了90.9% (74.7毫克) 到审查后12个月.
- bensodiazepine 的使用量下降了50%.
- 观察到SUD治疗的参与度增加和尿液药物检测的增加.
结论:
- 由临床药房从业人员领导的IDT病例审查过程在降低阿片类药物剂量和改善高风险退伍军人的风险减轻方面取得了成功.
- 这些发现突显了结构化跨学科审查在管理复杂患者群体方面的潜在有效性.
- 需要进一步的研究来探索这种干预措施的更广泛的适用性和长期影响.
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