药学学生主导的新开始抗凝药物用药咨询对患者预后和医疗保健利用的影响。

Innovations in pharmacy Pub Date : 2025-04-23 eCollection Date: 2025-01-01 DOI:10.24926/iip.v16i1.6368
Hannah P McCullough, Gracie K Daniels, Andrew Diaz, Tiffany A LaDow, Sarah Westbrook
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引用次数: 0

摘要

目的:虽然有证据表明药剂师主导的药物咨询提高了患者的安全性和结果,但药学专业学生对患者护理结果的影响却存在矛盾的证据。本研究的目的是探讨药学学生主导的新开始抗凝药物咨询与药剂师主导的新开始抗凝药物咨询是否对医疗保健利用有相似的影响。方法:本研究为多中心回顾性队列研究。主要结果是患者与医疗保健提供者的计划外接触(电话或MyChart信息)、急诊室(ED)就诊和出院后30天内再次住院的综合结果。新开始使用阿哌沙班、利伐沙班或华法林治疗新发肺栓塞或深静脉血栓的患者至少18岁。2022年1月1日至2023年6月30日期间,通过Epic上的图表回顾,从德克萨斯州中部的七个医疗中心收集了学生和药剂师主导的咨询数据。结果:共纳入575例患者。其中165例(29%)患者接受学生辅导,84例(15%)患者接受药师辅导,326例(57%)患者未接受辅导。440例(77%)患者在出院30天内有计划外的患者接触、急诊科就诊和/或再入院。在全因(p = 0.78)或出血相关(p = 0.23)的非计划患者接触、急诊科就诊和出院后30天内再入院方面,学生和药剂师主导的咨询没有差异。结论:本研究表明,学生主导的抗凝咨询与药剂师主导的抗凝咨询在患者预后和医疗保健利用方面没有差异。
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 Pharmacy Student-Led Medication Counseling for New Start Anticoagulants on Patient Outcomes and Healthcare Utilization.

Purpose: While there is evidence that pharmacist-led medication counseling improves patient safety and outcomes, there is conflicting evidence of the impact of pharmacy students on patient care outcomes. The objective of this study is to investigate if pharmacy student-led new-start anticoagulant medication counseling has a similar effect on healthcare utilization compared to pharmacist-led new start anticoagulant medication counseling. Methods: This study is a multicenter retrospective cohort study. The primary outcome is a composite of unplanned patient contact (phone call or MyChart message) with healthcare providers, emergency department (ED) visits, and hospital readmission within 30 days of discharge. Patients at least 18 years old that are newly started on apixaban, rivaroxaban, or warfarin for a new pulmonary embolism or deep vein thrombosis were included. Student- and pharmacist-led counseling data was collected from seven medical centers in central Texas between January 1, 2022 and June 30, 2023 via chart review on Epic. Results: There were 575 patients included in this study. Of these, 165 (29%) patients were counseled by students, 84 (15%) patients were counseled by pharmacists, and 326 (57%) patients were not counseled at all. 440 (77%) patients had unplanned patient contact, ED visit, and/or readmission within 30 days of discharge. There was no difference in all-cause (p = 0.78) or bleeding-related (p = 0.23) composite unplanned patient contact, ED visits, and readmissions within 30 days of discharge between student- and pharmacist-led counseling. Conclusion: This study suggests that student-led versus pharmacist-led anticoagulant counseling shows no difference in patient outcomes and healthcare utilization.

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