药师通过方案为基础的药物治疗管理的干预是有效的,以确保安全的侵入性手术治疗慢性肝病。

IF 1.2 Q4 PHARMACOLOGY & PHARMACY
Yuuka Shibata, Yuki Koga, Yuki Sato, Emiko Mashida, Tomokazu Kawaoka, Eisuke Murakami, Kei Amioka, Yusuke Johira, Kensuke Naruto, Takanori Taogoshi, Tomoharu Yokooji, Masataka Tsuge, Hiroaki Matsuo
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引用次数: 0

摘要

背景:慢性肝病患者在进行有创手术时应考虑出血性并发症的风险。血小板计数低的患者在手术前根据医生的判断给予血小板产品。然而,目前还没有标准来分配与每个手术相关的出血风险,也没有血小板计数来避免这些风险,也没有确定血小板计数的方法。在这项研究中,我们评估了药剂师是否可以通过推荐血小板生成素受体激动剂来减少血小板产品的使用,并使用基于方案的药物治疗管理来评估程序性出血风险和血小板计数。方法:在2022年8月至2023年2月期间计划接受侵入性手术的慢性肝病患者中,将术前由药剂师面谈的患者定义为干预组(n = 80),其余为非干预组(n = 224)。该方案旨在确定程序性出血风险和血小板计数。药剂师建议对血小板计数低于推荐值的患者开血小板生成素受体激动剂。结果:干预组和非干预组血小板产品和血小板生成素受体激动剂的使用率分别为0%和7.5%,3.1%和0%。在需要使用lusutrombopag的患者中,所有干预组患者均未使用血小板产品,仅使用lusutrombopag。然而,达到推荐血小板计数的患者比例在干预组和非干预组之间没有差异。结论:如果药剂师根据血小板计数和手术出血风险的评估建议处方血小板生成素受体激动剂,血小板产品的使用会减少,但出血的发生率不会增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pharmacist intervention through protocol-based pharmacotherapy management is effective to ensure safety in invasive procedures for chronic liver disease.

Background: The risk of hemorrhagic complications in patients with chronic liver disease during invasive procedures should be considered. Patients with low platelet counts were administered platelet products prior to procedures based on a physician's judgment. However, there are no standards for allocating the bleeding risk associated with each procedure, platelet counts to avoid these risks, or methods for determining platelet counts. In this study, we evaluated whether pharmacists could reduce the use of platelet products by suggesting thrombopoietin receptor agonists using protocol-based pharmacotherapy management to assess procedural bleeding risk and platelet counts.

Methods: Among patients with chronic liver disease who were scheduled to undergo invasive procedures between August 2022 and February 2023, those who were interviewed by a pharmacist prior to the procedures were defined as the intervention group (n = 80) and the others as the non-intervention group (n = 224). The protocol was to define the procedural bleeding risk and platelet count. Pharmacists suggested prescribing a thrombopoietin receptor agonist to patients with platelet counts below the recommended counts.

Results: The use of platelet products and thrombopoietin receptor agonists was 0% and 7.5% and 3.1% and 0% in the intervention and non-intervention groups, respectively. Among the patients who were required to receive lusutrombopag, all patients in the intervention groups did not receive platelet product but lusutrombopag alone. However, the rates of patients with the recommended platelet count were not different between the intervention and non-intervention groups.

Conclusions: The use of platelet products decreases without the increased incidences of hemorrhage if pharmacists suggest prescribing thrombopoietin receptor agonists based on their assessment of the platelet count and the bleeding risk of the procedure.

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来源期刊
CiteScore
1.80
自引率
0.00%
发文量
29
审稿时长
8 weeks
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