远程药剂师和导航员驱动的疾病管理计划的方法、原理和设计,以改善心血管和/或肾脏风险较高的 2 型糖尿病患者的指南指导下的药物治疗

IF 2.6 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM
Alexander J. Blood , Lee-Shing Chang , Caitlin Colling , Gretchen Stern , Daniel Gabovitch , Guinevere Feldman , Asma Adan , Fanta Waterman , Emily Durden , Carol Hamersky , Joshua Noone , Samuel J. Aronson , Paul Liberatore , Thomas A. Gaziano , Lina S. Matta , Jorge Plutzky , Christopher P. Cannon , Deborah J. Wexler , Benjamin M. Scirica
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引用次数: 0

摘要

目的描述糖尿病远程干预以提高循证药物使用率(DRIVE)的原理和设计,这是一项远程药物管理计划,旨在通过利用非医生医疗服务提供者,为心血管(CV)和/或肾脏风险较高的 2 型糖尿病(T2D)患者启动和滴定指南指导的医疗疗法(GDMT)。方法采用基于电子健康记录的算法,在我们的医疗系统中识别出患有 2 型糖尿病和已确诊的动脉粥样硬化性心血管疾病 (ASCVD)、ASCVD 高风险、慢性肾病和/或心力衰竭的患者。我们邀请患者参与,并随机分配患者同时接受教育和药物管理,或在药物管理前接受一段时间的教育。患者导航员(经过培训的非执业人员)是主要的联络人,药剂师或执业护士则在心脏病专家和/或内分泌专家的监督下,根据机构批准的合作药物治疗管理方案审查和授权每次用药和滴定。结论我们正在测试一种远程、导航员驱动、药剂师主导、医生监督的管理策略,以优化 T2D 的 GDMT,作为一种人群策略,缩小指南与临床实践之间的差距,用于治疗心血管和/或肾脏风险较高的 T2D 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。
Methods, rationale, and design for a remote pharmacist and navigator-driven disease management program to improve guideline-directed medical therapy in patients with type 2 diabetes at elevated cardiovascular and/or kidney risk

Aim

Describe the rationale for and design of Diabetes Remote Intervention to improVe use of Evidence-based medications (DRIVE), a remote medication management program designed to initiate and titrate guideline-directed medical therapy (GDMT) in patients with type 2 diabetes (T2D) at elevated cardiovascular (CV) and/or kidney risk by leveraging non-physician providers.

Methods

An electronic health record based algorithm is used to identify patients with T2D and either established atherosclerotic CV disease (ASCVD), high risk for ASCVD, chronic kidney disease, and/or heart failure within our health system. Patients are invited to participate and randomly assigned to either simultaneous education and medication management, or a period of education prior to medication management. Patient navigators (trained, non-licensed staff) are the primary points of contact while a pharmacist or nurse practitioner reviews and authorizes each medication initiation and titration under an institution-approved collaborative drug therapy management protocol with supervision from a cardiologist and/or endocrinologist. Patient engagement is managed through software to support communication, automation, workflow, and standardization.

Conclusion

We are testing a remote, navigator-driven, pharmacist-led, and physician-overseen management strategy to optimize GDMT for T2D as a population-level strategy to close the gap between guidelines and clinical practice for patients with T2D at elevated CV and/or kidney risk.

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来源期刊
Primary Care Diabetes
Primary Care Diabetes ENDOCRINOLOGY & METABOLISM-PRIMARY HEALTH CARE
CiteScore
5.00
自引率
3.40%
发文量
134
审稿时长
47 days
期刊介绍: The journal publishes original research articles and high quality reviews in the fields of clinical care, diabetes education, nutrition, health services, psychosocial research and epidemiology and other areas as far as is relevant for diabetology in a primary-care setting. The purpose of the journal is to encourage interdisciplinary research and discussion between all those who are involved in primary diabetes care on an international level. The Journal also publishes news and articles concerning the policies and activities of Primary Care Diabetes Europe and reflects the society''s aim of improving the care for people with diabetes mellitus within the primary-care setting.
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