药物使用障碍患者跨学科初级保健模式下心理健康临床药剂师的护理实践。

IF 2.8 3区 医学 Q2 SUBSTANCE ABUSE
Substance abuse Pub Date : 2023-10-01 Epub Date: 2023-10-15 DOI:10.1177/08897077231198679
Annette Percy, A Taylor Kelley, Natalie Valentino, Amy Butz, Jacob D Baylis, Ying Suo, Adam J Gordon, Audrey L Jones
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引用次数: 0

摘要

背景:临床药剂师在药物使用障碍患者的跨学科护理中发挥着越来越重要的作用。然而,CP的执业范围因诊所和环境而异。目的:我们试图描述CPP在一个跨学科、团队基础的初级保健诊所内的实践和活动,该诊所致力于治疗有药物使用障碍史、无家可归经历、高度医疗复杂性和其他脆弱性的退伍军人。方法:我们使用退伍军人事务部(VA)2019年的行政数据对CPP活动进行了回顾性队列研究。结果:CPP为228名患者提供了护理,包括766次门诊就诊、341次电话就诊和626次图表审查,平均2.5 每位患者每年花费的小时数。CPP患者经常出现心理健康状况和SUD,包括抑郁症(66%)、创伤后应激障碍(52%)、阿片类药物使用障碍(OUD)(45%)和酒精使用障碍(44%)。在76名患者(33%)中,CPPs管理丁丙诺啡药物治疗OUD或慢性疼痛。大多数CPP干预措施(共3330项)针对SUD(33%)、心理健康状况(24%)和疼痛管理(24%),SUD干预措施包括药物开始、剂量变化、停药和监测。作为阿片类药物风险缓解工作的一部分,CP对该州的处方药监测计划进行了769次询问,并为指定患者订购了59个纳洛酮试剂盒和661个实验室小组。结论:CPPs管理了大量易受伤害的患者,并在跨学科的初级保健团队中提供了复杂的护理。类似的CPP角色可以在其他初级保健环境中实施,以增加获得SUD治疗的机会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Care Practices of Mental Health Clinical Pharmacist Practitioners Within an Interdisciplinary Primary Care Model for Patients With Substance Use Disorders.

Background: Clinical pharmacist practitioners (CPPs) play an increasingly important role in interdisciplinary care for patients with substance use disorders (SUDs). However, CPPs' scope of practice varies substantially across clinics and settings.

Objectives: We sought to describe CPP practices and activities within an interdisciplinary, team-based primary care clinic dedicated to treat Veterans with histories of substance use disorders, experience of homelessness, high medical complexity, and other vulnerabilities.

Methods: We conducted a retrospective cohort study of CPP activities using Department of Veterans Affairs (VA) administrative data in 2019.

Results: CPPs provided care for 228 patients, including 766 in-clinic visits, 341 telephone visits, and 626 chart reviews, with an average of 2.5 hours spent per patient per year. Patients seen by CPPs frequently experience mental health conditions and SUDs, including depression (66%), post-traumatic stress disorder (52%), opioid use disorder (OUD) (45%), and alcohol use disorder (44%). CPPs managed buprenorphine medications for OUD or chronic pain in 76 patients (33%). Most CPP interventions (3330 total) were for SUDs (33%), mental health conditions (24%), and pain management (24%), with SUD interventions including medication initiation, dose changes, discontinuations and monitoring. As part of opioid risk mitigation efforts, CPPs queried the state's prescription drug monitoring program 769 times and ordered 59 naloxone kits and 661 lab panels for empaneled patients.

Conclusion: CPPs managed a high volume of vulnerable patients and provided complex care within an interdisciplinary primary care team. Similar CPP roles could be implemented in other primary care settings to increase access to SUD treatment.

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来源期刊
Substance abuse
Substance abuse SUBSTANCE ABUSE-
CiteScore
5.90
自引率
2.90%
发文量
88
审稿时长
>12 weeks
期刊介绍: Now in its 4th decade of publication, Substance Abuse journal is a peer-reviewed journal that serves as the official publication of Association for Medical Education and Research in Substance Abuse (AMERSA) in association with The International Society of Addiction Medicine (ISAM) and the International Coalition for Addiction Studies in Education (INCASE). Substance Abuse journal offers wide-ranging coverage for healthcare professionals, addiction specialists and others engaged in research, education, clinical care, and service delivery and evaluation. It features articles on a variety of topics, including: Interdisciplinary addiction research, education, and treatment Clinical trial, epidemiology, health services, and translation addiction research Implementation science related to addiction Innovations and subsequent outcomes in addiction education Addiction policy and opinion International addiction topics Clinical care regarding addictions.
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