基于医院-社区药剂师合作的心力衰竭管理协议的影响
Junichi Terashima1,2, Takahiro Kambara3, Eisei Hori4,5
1Department of Pharmacy, Tosei General Hospital, 160, Nishioiwake-cho, Seto, Aichi, 489- 8642, Japan.
Journal of pharmaceutical health care and sciences
|March 13, 2025
概括
日本的社区药剂师现在可以使用新的协议有效地管理心力衰竭. 这种干预显著减少了心力衰竭的再入院,改善了患者的治疗结果,降低了医疗保健负担.
科学领域:
- 药理学 药理学是指药理学的学科.
- 心脏病学 心脏病学
- 公共卫生 公共卫生
背景情况:
- 心力衰竭 (HF) 与高的住院再接收率有关.
- 多学科干预措施是有效的管理HF.
- 在日本,需要为社区药剂师领导的HF管理制定标准化协议.
研究的目的:
- 为日本社区药剂师开发和验证一种新的心力衰竭管理协议.
- 评估该协议在减少心力衰竭再入院的有效性.
主要方法:
- 与药剂师合作,制定了一项定期患者随访和恶化管理的协议.
- 在2022年3月至2023年9月期间,68名心力衰竭患者被录取.
- 接受社区药剂师随访的患者组成了干预组;其他人是对照组.
主要成果:
- 卡普兰-梅尔分析和考克斯回归显示,干预组中360天内心力衰竭再入院的发生率显著降低 (p=0.031).
- 再接收的危险比率为0.28 (95% CI:0.09-0.89).
结论:
- 一个结构化的心力衰竭管理协议使社区药剂师能够有效地管理患者.
- 这种方法显著减少了不良事件,特别是心力衰竭的再入院.
相关概念视频
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
356
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
356
Heart Failure Drugs: Diuretics
313
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
313
Heart Failure Drugs: β-Blockers
300
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
300
Pathophysiology of Heart Failure
1.4K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.4K
Methods of Documentation VI: Case Management Model
557
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
For example, a patient with a chronic...
557
Heart Failure Drugs: Inotropic Agents
481
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
481


