作者:Samuel L. Ellis、Sarah J. Billups、Daniel C. Malone、Barry L. Carter、Douglas Covey、Barbara Mason、Sandra Jue、Jannet Carmichael、Kelly Guthrie、Charles D. Sintek、Robert Dombrowski、Douglas R. Geraets、Mary Amato
DOI:10.1592/phco.20.5.429.35055
日期:2000.4
The purpose of this study was to describe and evaluate the activities and interventions provided by ambulatory care clinical pharmacists during the IMPROVE (Impact of Managed Pharmaceutical Care on Resource Utilization and Outcomes in Veterans Affairs Medical Centers) study. A total of 523 patients were randomized into the intervention arm at nine Veterans Affairs medical centers if they were considered to be at high risk for drug-related problems. Patients randomized to the control group had no interventions and they are not reported. Using a standard form, pharmacists were asked to document the length of visit, method of contact, medical conditions addressed, and drug-related problems addressed and resolved during each contact. Seventy-eight ambulatory care clinical pharmacists documented 1855 contacts over 12 months, an average of 3.54 ± 2.31/patient. The length of visits was 15 minutes or more for 73% of contacts. In-person contacts accounted for 1421 visits (76.6%), with the remainder being telephone contacts. During each contact the average number of drug-related problems addressed and resolved were 1.64 ± 1.16 and 1.14 ± 0.98, respectively. More drug-related problems were addressed and resolved when visits were 15 minutes or longer (p= 0.001) and when the contact was in person (p= 0.001). These data may provide information to clinical pharmacists developing pharmacy-managed clinics for patients at high risk for drug-related problems. The information may be a benchmark for types of interventions that can be made, as well as the time commitments required to make them.
本研究的目的是描述和评估在IMPROVE(影响管理式药品护理在退伍军人事务医疗中心的资源利用和结果)研究中,门诊护理临床药师提供的活动和干预措施。共有523名患者在九个退伍军人事务医疗中心被随机分配到干预组,前提是他们被认为存在药物相关问题的较高风险。被随机分配到对照组的患者没有接受任何干预,因此不在此报告中。药师们被要求使用标准表格来记录每次联系的时长、联系方式、处理的医疗状况以及解决的药物相关问题。78名门诊护理临床药师在12个月内记录了1855次联系,平均每位患者3.54 ± 2.31次。在73%的联系中,访问时长为15分钟或更长。面对面接触占1421次(76.6%),其余为电话联系。每次联系中,平均处理的药物相关问题数量分别为1.64 ± 1.16和1.14 ± 0.98。当访问时长为15分钟或更长时(p=0.001)以及当接触为面对面时(p=0.001),处理和解决的药物相关问题更多。这些数据可能为临床药师开发针对药物相关问题高风险患者的药房管理诊所提供信息。这些信息可能成为可以进行的干预类型的基准,以及进行这些干预所需的时间承诺。