药师主导的教育和干预计划改善高血压患者的预后。

Alicia L Zagel, Adam Rhodes, Jeri Nowak, Amanda R Brummel
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引用次数: 0

摘要

目的:未控制的高血压是严重的,可能导致严重的心血管事件和死亡。为了更好地教育和授权患者实现他们的血压管理目标,一个大型的综合学术医疗保健系统实施了血压目标实现计划(BPGAP),这是一项将社区药剂师纳入医疗保健团队的纵向干预。本研究评估了BPGAP促进患者血压管理目标的能力。方法:进行干预前/干预后分析,通过k-means聚类方法对急性组内的血压测量进行纵向评估。广义线性混合模型评估了不同时间段的血压变化趋势,以及达到血压管理目标的患者比例(结果:5125例患者分为血压不受控制组、边缘组和控制组;2108名患者在BPGAP入组前后的4个时间段进行了血压测量。各组根据患者年龄、性别和其他人口统计数据而不同(结论:BPGAP能有效帮助患者实现血压管理目标。药剂师可以通过测量血压、在电子健康记录中包含更新和建议、教育患者以及参与与医疗团队的沟通,在高血压控制中发挥关键作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

A Pharmacist-Driven Education and Intervention Program that Improves Outcomes for Hypertensive Patients.

A Pharmacist-Driven Education and Intervention Program that Improves Outcomes for Hypertensive Patients.

A Pharmacist-Driven Education and Intervention Program that Improves Outcomes for Hypertensive Patients.

Purpose: Uncontrolled hypertension is serious and may lead to severe cardiovascular events and death. To better educate and empower patients to meet their blood pressure (BP) management goals, a large, integrated academic healthcare system implemented the Blood Pressure Goals Achievement Program (BPGAP), a longitudinal intervention embedding community pharmacists within healthcare teams. This study evaluated BPGAP on its ability to promote patient BP management goals. Methods: A pre-/post-intervention analysis was conducted whereby BP measurements were evaluated longitudinally within acuity groups determined by k-means clustering. Generalized linear mixed models evaluated trends in BP by time period, and proportions of patients meeting BP management goals (<140/90 mmHg) were assessed in relation to BPGAP enrollment date. Results: There were 5,125 patients who were clustered into Uncontrolled, Borderline, and Controlled blood pressure groups; 2,108 patients had BP measurements across 4 time periods before and after BPGAP enrollment. Groups differed by patient age, sex, and other demographics (p<0.0001). Patients in the Uncontrolled and Borderline BP clusters demonstrated significant BP decreases after BPGAP enrollment, continuing at least to 1-year post-intervention; Controlled cluster patients maintained BPs throughout the study period. The proportion of patients with controlled BPs increased from 56% immediately pre-BPGAP to 74% in the 3- to 6-months following enrollment. Conclusion: BPGAP is effective at helping patients achieve their BP management goals. Pharmacists may play a key role in hypertension control through measuring BPs and including updates and recommendations in the electronic health record, educating patients, and engaging in communication with healthcare teams.

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