超过 20 万次直接面向消费者的远程医疗会诊中的多种药物管理和指南遵守情况。

IF 1.1 Q2 MEDICINE, GENERAL & INTERNAL
Einstein-Sao Paulo Pub Date : 2024-07-08 eCollection Date: 2024-01-01 DOI:10.31744/einstein_journal/2024AO0707
Flavio Tocci Moreira, Tarso Augusto Duenhas Accorsi, Karine De Amicis, Karen Francine Köhler, Renata Albaladejo Morbeck, Eduardo Cordioli, Carlos Henrique Sartorato Pedrotti
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引用次数: 0

摘要

目的:远程医疗出院的疑似呼吸道感染患者的护理质量和安全性与低不合理和高风险药物处方率密切相关。这项回顾性研究旨在评估一家大型中心在使用多种药物管理协议的直接对消费者远程医疗会诊中对现行 COVID-19 指南的遵守情况:方法:利用医生个人护理的医疗记录进行季度电子调查,评估各种质量指标。医生根据个人指标不断收到适应性反馈,远程医疗中心的建议来自于美国传染病学会 2020 年指南。该研究包括在 2020 年 3 月至 2021 年 8 月期间,所有在过去 14 天内出现新呼吸道症状并自发寻求远程医疗会诊的连续成人患者。该研究分析了疑似或确诊为 COVID-19 和其他气道感染的患者:在 221 128 名接受评估的患者中,42 042 人(19%)确诊为 COVID-19;104 021 人(47%)疑似 COVID-19;75 065 人(33%)有其他诊断。疑似或确诊 COVID-19 患者的平均年龄(+DP)为 35±12 岁。共有125107名(85.65%)患者在家中接受了治疗,2552名(1.74%)患者被转诊至非急诊诊室进行复查,17185名(11.7%)患者被转诊至急诊科,但没有进一步的治疗建议。COVID-19确诊或疑似病例的抗生素使用率为0.46%/0.65%,非循证处方的抗生素使用率为0.01%/0.005%:结论:指南培训和远程医疗咨询反馈可降低疑似和确诊 COVID-19 病例的抗生素和抗菌药物处方率。多种药物管理协议可提高指南的依从性,加强远程医疗会诊的护理质量和安全性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Multidrug stewardship and adherence to guidelines in >200,000 direct-to-consumer Telemedicine encounters.

Objective: The quality of care and safety for Telemedicine-discharged patients with suspected respiratory infections are closely related to low rates of prescriptions of unjustified and high-risk medications. This retrospective study aimed to assess adherence to the current COVID-19 guidelines in direct-to-consumer telemedicine encounters at a large center using multidrug stewardship protocols.

Methods: A quarterly electronic survey utilizing medical records of individual physician care assessed various quality indicators. Physicians received ongoing adaptive feedback based on personal metrics, with Telemedicine Center recommendations derived from the 2020 Infectious Diseases Society of America guidelines. The study included all consecutive adults with new respiratory symptoms in the last 14 days who sought spontaneous Telemedicine consultations between March 2020 and August 2021. This study analyzed patients with suspected or confirmed COVID-19 and other airway infections.

Results: Of the 221,128 evaluated patients, 42,042 (19%) had confirmed COVID-19; 104,021 (47%) were suspected to have COVID-19; and, 75,065 (33%) had other diagnoses. Patients with suspected or confirmed COVID-19 had a mean (+DP) age of 35±12 years. A total of 125,107 (85.65%) patients were managed at home, 2,552 (1.74%) were referred for non-urgent in-office reassessment, and 17,185 (11.7%) were referred to the emergency department for whom there was no further treatment recommendation. The antibiotic rate in confirmed or suspected COVID-19 cases was 0.46%/0.65% and that for non-evidence-based prescriptions was 0.01%/0.005%.

Conclusion: Guideline training and Telemedicine consultation feedback may lead to lower antibiotic and antimicrobial prescriptions in suspected and confirmed COVID-19 cases. Multidrug stewardship protocols may improve guideline adherence and reinforce the quality of care and safety in Telemedicine encounters.

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Einstein-Sao Paulo
Einstein-Sao Paulo MEDICINE, GENERAL & INTERNAL-
CiteScore
2.00
自引率
0.00%
发文量
210
审稿时长
38 weeks
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