简化PCI后药物获取,以改善DAPT的遵守和结果
Gregory Desrosiers1, Mary McCollough2, Jessie Lipstreuer3
1Department of Cardiology, University of Tennessee Graduate Medical Education, Knoxville, Tennessee, USA.
JACC. Case reports
|November 14, 2025
概括
整合医院门诊药房服务改善了皮肤冠状动脉干预 (PCI) 后患者获得双重抗血小板治疗的机会. 这一举措减少了处方延迟和提高了药物坚持,这对于预防支架血栓形成至关重要.
科学领域:
- 心血管医学 心血管医学
- 医疗保健系统 药房 药房
- 干预心脏病学 干预心脏病学
背景情况:
- 双抗血小板疗法 (DAPT) 是通过皮肤进行冠状动脉干预后 (PCI) 预防支架血栓形成的重要手段.
- 诸如成本,保险,患者理解和药房库存等障碍限制了DAPT的启动和遵守.
- 社区药房经常缺乏新的,昂贵的P2Y12抑制剂,导致处方延迟.
研究的目的:
- 为了减少及时启动DAPT和PCI后遵守的障碍.
- 将医院门诊药房服务纳入PCI患者的出院计划.
- 为了改善患者获得必不可少的P2Y12抑制剂.
主要方法:
- 一个多学科的团队将P2Y12抑制剂的处方指导到医院的门诊药房.
- 服务包括财政援助,加快事先授权,并在出院前在床边分娩.
- 在实施前和之后,对处方填充率进行了审计.
主要成果:
- 在实施前,外部处方填充率各不相同 (例如,5/9 提卡格勒尔,3/3 克洛皮多格勒尔,9/10 普拉苏格勒尔).
- 实施后,99.1%的处方成功填充并送达床边.
- 综合方法显著改善了药物可用性.
结论:
- 利用医院药房资源可以确保门诊PCI患者迅速获得DAPT.
- 这种模式增强了药物坚持,并降低了不良心血管事件的风险.
- 简化药房服务对于优化PCI后护理至关重要.
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