专家心力衰竭药剂师处方诊所的实施和评估
Gayle Campbell1, Ciara Doherty2, Andrew D'Silva2
1Cardiology Department, Guy's and St Thomas' NHS Foundation Trust, London, SE1 7EH, UK. gayle.campbell2@nhs.net.
International journal of clinical pharmacy
|October 5, 2024
概括
心力衰竭 (HF) 药剂师在三个月内显著改善药物坚持和优化治疗. 专门的HF药剂师诊所加强了指导方针导向的医学治疗,改善了患者的治疗结果.
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.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 药物坚持对于心力衰竭 (HF) 管理至关重要,未经治疗的HF的死亡率超过30%.
- 专家心力衰竭 (HF) 药剂师是多学科团队的组成部分,在处方和坚持促进方面提供专业知识.
研究的目的:
- 实施专门的HF药剂师处方诊所.
- 评估这些HF专业药剂师诊所对患者结局的影响.
主要方法:
- 一个伦敦三级医院的综合性HF团队建立了专门的HF药剂师处方诊所.
- 创建了一个专门的电子推途径,将推标准扩展到所有需要医疗疗优化的患者.
- 在2021年9月至2022年7月期间,对114名心力衰竭患者进行了回顾性数据收集,其中包括心力衰竭和减少喷射率 (HFrEF) 的患者.
主要成果:
- 接受优化指南导向医疗疗 (GDMT) 的患者比例显著增加,从首次预约的8%增加到出院时的76% (p < 0.001).
- 药物优化通常在三个月内实现,平均每月约会一次.
- 高频药剂师对17.5%的患者进行了非高频药物的审查和优化.
结论:
- 专业的高频药剂师在大约三个月内有效地优化了高频和非高频的医疗治疗.
- 由HF药剂师进行的整体药物审查解决了HF治疗方法的不足,从而改善了患者的治疗结果.
- 实施专业的HF药剂师诊所是加强心力衰竭护理的重要策略.
相关概念视频
01:22Heart Failure VI: Adjunct Therapies
5
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
5
01:30Heart Failure V: Nursing Interventions
2
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
2
01:29Cardiomyopathy V: Interprofessional Care
2
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
2
01:30Heart Failure IV: Classification and Diagnostic Evaluation
2
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
2
01:30Heart Failure V: Medical Management
2
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
2
01:28Acute Coronary Syndrome IV: Interprofessional Care
3
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
3