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在初级保健环境中实施药剂师驱动的GABAPENTINOID定位用于糖尿病外围神经病变
Emma Eibye1, Julie M Waldfogel2, Patricia A Ross2
1PGY-2 Ambulatory Care Pharmacy Resident, The Johns Hopkins Hospital, Baltimore, MD, USA.
Journal of pain & palliative care pharmacotherapy
|November 22, 2024
概括
对于糖尿病外围神经病变 (DPN) 的药剂师干预旨在优化 gabapentinoid 的剂量. 虽然疼痛有所改善,但没有达到最低有效剂量,大多数患者拒绝进一步的服务.
科学领域:
- 药理学 药理学是指药理学的学科.
- 神经学 神经学
- 临床药房 临床药房
背景情况:
- 患有糖尿病外围神经病变 (DPN) 的患者经常接受治疗次的加巴类药剂.
- 国家指导方针建议在DPN管理中使用最低有效的加巴丁剂量.
- 需要评估药剂师主导的干预措施,以优化DPN治疗.
研究的目的:
- 评估药剂师对DPN患者的干预措施的实施,这些患者无法达到最低有效的 gabapentinoid 剂量.
- 评估药剂师在优化止痛药剂剂量和DPN的管理中的作用.
主要方法:
- 一个初级保健诊所的前景,单站点质量改善项目.
- 包括DPN患者,他们的初级保健提供者 (PCP) 处方了亚治疗性 gabapentinoid 剂量.
- 药剂师根据临床判断对疼痛,不良反应,功能和剂量定位的评估.
主要成果:
- 所有跟踪的患者 (到第13周) 均显示出临床显著的疼痛改善.
- 没有患者在疼痛得分下降了50%或达到最低有效剂量.
- 大多数患者拒绝了进一步的药剂师服务,报告他们的神经病变得到控制.
结论:
- 药剂师可以评估患者特定的因素,以优化止痛剂的剂量,定位和减轻DPN的处方.
- 目前的 gabapentinoid 剂量对于一些 DPN 患者来说可能是充足的,尽管它没有达到指导方针推的最低值.
- 需要进一步的研究来完善DPN治疗策略和以患者为中心的护理模式.
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