实施处方医师和药剂师的合作,以改善基于证据的药物处方,使用异步,不中断的电子健康记录通知
Geoffrey D Barnes1, Seo Youn Choi2, Michael Sm Lanham3
1Frankel Cardiovascular Center and Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA. gbarnes@umich.edu.
Implementation science : IS
|December 16, 2025
概括
电子健康记录通知有效地促使对不适当的直接口服抗凝剂 (DOAC) 处方进行纠正. 临床药剂师在复杂病例中表现出专业知识,这表明他们的参与是提高药物安全性的有效策略.
科学领域:
- 药理学 药理学是指药理学的学科.
- 医疗信息学 医疗信息学
- 临床药房 临床药房
背景情况:
- 不适当的直接口服抗凝剂 (DOAC) 处方会导致不良事件.
- 基于电子健康记录 (EHR) 的通知可以改善基于证据的处方.
- 通过EHR通知,让临床药剂师参与可能会提高药物安全性.
研究的目的:
- 评估基于EHR的通知在纠正不适当的DOAC处方方面的有效性.
- 为了比较面向处方医生和临床药剂师的通知的影响.
- 确定影响采用处方变化的因素.
主要方法:
- 实用性,随机化实施试验进行.
- 对不适当的DOAC处方发送了异步的EHR通知.
- 通知是针对处方的临床医生或临床抗凝药药师.
- 主要结局是7天内改变处方.
主要成果:
- 总体而言,23.2%的通知导致在7天内改变处方.
- 向药剂师发送的通知显示了21%的变化率,而向处方者发送的通知显示了26%的变化率 (p=0.36).
- 药剂师表现出更一致的复杂病例管理,包括多药和剂量门问题.
结论:
- 处方者和药剂师都对纠正DOAC处方的EHR通知做出了类似的反应.
- 临床药剂师在复杂的场景中对指南的细微应用.
- 直接吸引临床药剂师是解决处方问题的有效策略,特别是在复杂的病例中.
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