药剂师药物定位计划为患有心脏沙丘病症和静心性心力衰竭的患者:一个回顾性队列研究
Daniel Sykora1, Nicole Olson2, Robert Churchill3
1Mayo Clinic School of Graduate Medical Education Rochester MN.
Journal of the American Heart Association
|November 18, 2024
概括
一个由药剂师领导的药物治疗管理计划改善了指导方针导向的医疗治疗,并减少了心力衰竭患者心脏类症的心血管不良事件.
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.
- 免疫学 免疫学 免疫学
背景情况:
- 准则导向的医学治疗 (GDMT) 对于静心性心力衰竭 (HF) 是至关重要的.
- 多学科方法的有效性,包括药剂师主导的计划,在优化GDMT对HF的有效性,特别是由于心脏沙丘症,仍未得到充分探索.
- 心脏类沙丘病在治疗高血压方面存在独特的挑战,需要量身定制的治疗策略.
研究的目的:
- 评估药剂师主导的药物治疗管理 (MTM) 计划对高血压和心脏沙尔科病症患者的GDMT优化的影响.
- 在这个特定的患者群体中,评估MTM参与与心血管结果之间的关联.
- 将接受MTM和不接受MTM的患者之间的GDMT坚持和临床结果进行比较.
主要方法:
- 对111名被诊断患有心脏沙尔科毒症和HF (左心室喷射率<50%) 的患者进行了回顾性队列研究.
- 患者被分为两组:参加药剂师领导的MTM计划的患者和非MTM对照组.
- 关键评估包括堪萨斯城医疗优化得分的变化,左心室喷射率和心血管无事件生存率在16个月的中位数随访期间.
主要成果:
- 无论是MTM和非MTM组在堪萨斯市医疗优化得分都显示出显著的改善,但MTM组在随访时获得了更高的得分 (74.8比58.7,P=0.001).
- 左心室喷射分数在MTM组 (44.4%对40.0%,P=0.05) 中呈现了改善的趋势.
- 主要心血管不良事件的发生率 (无计划的HF住院,LVAD/移植或死亡) 在MTM组显着较低 (2.3%对23.5%,HR11.97,P=0.002).
结论:
- 药剂师主导的MTM计划与心脏沙丘症和高血压患者的改善GDMT优化有关.
- 参与MTM显著降低了该患者队列中不良心血管结果的风险.
- 这些发现支持将药剂师主导的MTM服务整合到由于心脏沙丘病引起的HF患者的护理中.
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