跨学科患者护理模式和常规筛查对丙型肝炎患者临床结局的影响。

Innovations in pharmacy Pub Date : 2023-10-10 eCollection Date: 2023-01-01 DOI:10.24926/iip.v14i2.5114
Vincent Lam, Christine Dimaculangan
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引用次数: 0

摘要

据报道,医院急诊科(ED)的丙型肝炎检测和与诊所的护理联系为筛查患者和促进持续护理提供了最大的机会。治疗模式举措已扩大到包括远程保健服务和向药剂师等非医生提供者开放治疗能力。本研究的目的是评估实施丙型肝炎病毒(HCV)自动常规筛查和临床药师纳入跨学科护理模式对HCV诊断和治疗结果的影响。这项回顾性队列研究比较了干预前组和干预后组的结果。患者在泽西城医疗中心(JCMC)进行筛查和诊断为HCV,并完成与JCMC综合护理中心的联系。干预措施是在急诊科实施自动常规HCV筛查,并在跨学科患者护理模式中增加临床药剂师。主要终点分析了治疗12周后达到持续病毒学应答(SVR12)的患者数量,以及完成治疗但未报告SVR12记录的患者数量。次要终点分析了失去随访的患者数量、预约类型、预约时间和临床药剂师专家干预。数据作为分类变量收集,卡方检验评估两个样本之间是否存在差异。数据来自干预前组46例患者和干预后组37例患者。患者以男性为主。年龄从27岁到83岁不等。种族包括黑人、白人、亚洲人和其他种族。这项研究的结果显示了对实施常规筛查、远程医疗服务和HCV诊断和管理的跨学科团队方法的积极影响。考虑到时间范围,它还显示了在全球大流行期间对这些干预措施的潜在积极影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of an interdisciplinary patient care model and routine screening on clinical outcomes in patients with hepatitis C.

Testing for hepatitis C in hospital emergency departments (ED) and linkage to care to clinics have been reported to provide the most opportunity for screening patients and facilitating continuum of care. Treatment model initiatives have expanded to include telehealth services and open treatment capacity to non-physician providers, such as pharmacists. This study's objective was to assess the impact of implementing automated routine screening for hepatitis C virus (HCV) and a clinical pharmacist into the interdisciplinary care model on HCV diagnosis and treatment outcomes. This retrospective cohort study compared outcomes in a pre-intervention and post-intervention group. Patients were screened and diagnosed with HCV at Jersey City Medical Center (JCMC) and completed linkage to care at JCMC Center for Comprehensive Care. Interventions were the implementation of automated routine HCV screening in the ED and addition of a clinical pharmacist to the interdisciplinary patient care model. Primary endpoints analyzed the number of patients who have achieved sustained virologic response after 12 weeks of treatment (SVR12) and patients who have completed treatment with no reported record of SVR12. Secondary endpoints analyzed the number of patients lost to follow-up, appointment type, time spent in appointments, and clinical pharmacist specialist interventions. Data was collected as categorical variables and chi-squared tests assessed if there were differences between the two samples. Data was collected from 46 patients in the pre-intervention group and 37 patients in the post-intervention group. Patients consisted of mostly males. Ages ranged from 27 to 83 years old. Race included Black, White, Asian, and Other. This study's results showed the positive impact on implementation of routine screening, telehealth services, and an interdisciplinary team approach to HCV diagnosis and management. Given the timeframe, it also showed the potential positive impact on these interventions during a global pandemic.

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