评估基于人群的直接口服抗凝剂管理方法

IF 1.1 Q4 PHARMACOLOGY & PHARMACY
Nghi B Ha, Erin Mouland, E. Renner, Denise Sutter-Long, Anisa Bici, Michael Lanham, Geoffrey D. Barnes
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引用次数: 0

摘要

背景:随着人们对口服抗凝药的偏好从华法林转向直接口服抗凝药(DOACs),需要一种新的护理管理模式。一家学术医疗中心采用了一种利用 DOAC 控制面板的群体方法,以跟踪由医生随访的所有使用 DOAC 的患者。DOAC Dashboard 是电子病历 (EHR) 中的一份实时报告,用于识别因肾功能、年龄、体重、适应症和/或重大药物相互作用 (DDI) 变化而需要对 DOAC 剂量/疗法调整进行评估的患者。研究目的本研究旨在描述 DOAC Dashboard 实施的初始阶段,评估干预措施的有效性,并评估多学科管理方法。方法:对 DOAC Dashboard 进行回顾性描述研究:从 2019 年 8 月 22 日至 2022 年 1 月 20 日对 DOAC Dashboard 进行回顾性描述研究。主要结果包括处理的警报总数和所需干预措施。次要结果是处方临床医生实施干预的比例。结果:DOAC Dashboard 在基线共识别了 10 912 名患者。共识别出 5038 个警报,其中包括 668 个关键警报、3337 个可能的关键警报和 1033 个其他警报。药剂师在研究期间处理了 1796 个警报(762 个严重警报和 1034 个可能的严重警报)。重大警报包括 62 个重大 DDI、379 个用药不当和 321 个其他警报。在严重警告中,291 例(38%)需要采取干预措施,其中 255 例(88%)建议采取干预措施。不需要干预的严重警告和可能的严重警告通过数据录入得到了解决。结论DOAC Dashboard 提供了一种有效的方法,可识别服用 DOACs 且需要调整剂量或改变治疗方法的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessment of Population-Based Approach to Direct Oral Anticoagulant Management
Background: As preferences for oral anticoagulation shift from warfarin to direct oral anticoagulants (DOACs), a new care management model is needed. A population approach leveraging a DOAC Dashboard was implemented to track all patients on a DOAC followed by a physician at an academic medical center. The DOAC Dashboard is a real-time report within the electronic health record (EHR) that identifies patients who require evaluation for DOAC dose/therapy adjustment due to changing renal function, age, weight, indication, and/or significant drug-drug interaction (DDI). Objective: This study aims to describe the initial phase of DOAC Dashboard implementation, to evaluate the effectiveness of interventions, and to assess a multidisciplinary approach to management. Method: Retrospective descriptive study of the DOAC Dashboard from August 22, 2019, to January 20, 2022. Primary outcomes include total number of alerts addressed and interventions needed. Secondary outcome is the proportion of interventions implemented by the prescribing clinician. Result: A total of 10 912 patients were identified by the DOAC Dashboard at baseline. A total of 5038 alerts were identified, with 668 critical alerts, 3337 possible critical alerts, and 1033 other alerts. Pharmacists addressed 1796 alerts during the study period (762 critical alerts and 1034 possible critical). Critical alerts included 62 significant DDI, 379 inappropriate dosing, and 321 others. Of the critical alerts, intervention was needed in 291 cases (38%), with 255 (88%) of proposed interventions implemented. Critical alerts and possible critical alerts not requiring intervention were resolved by data entry. Conclusion: The DOAC Dashboard provides an efficient method of identifying patients on DOACs that require dose adjustments or therapeutic modifications.
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来源期刊
Journal of Pharmacy Technology
Journal of Pharmacy Technology PHARMACOLOGY & PHARMACY-
CiteScore
1.50
自引率
0.00%
发文量
49
期刊介绍: For both pharmacists and technicians, jPT provides valuable information for those interested in the entire body of pharmacy practice. jPT covers new drugs, products, and equipment; therapeutic trends; organizational, legal, and educational activities; drug distribution and administration; and includes continuing education articles.
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