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首页> 外文期刊>Journal of Pharmaceutical Health Care and Sciences >Pharmacist-physician collaborative care for outpatients with left ventricular assist devices using a cloud-based home medical management information-sharing system: a case report
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Pharmacist-physician collaborative care for outpatients with left ventricular assist devices using a cloud-based home medical management information-sharing system: a case report

机译：药剂师 - 医师使用基于云的家庭医疗管理信息共享系统的左心室辅助设备的门诊病人的合作护理：案例报告

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Abstract Background The standard anticoagulation therapy for patients implanted with left ventricular assist devices (LVADs) includes warfarin therapy. We developed a cloud-based home medical management information-sharing system named as LVAD@home. The LVAD@home system is an application designed to be used on iPad tablet computers. This system enables the sharing of daily information between a patient and care providers in real time. In this study, we reported cases of outpatients with LVADs using this system to manage anticoagulation therapy. Case presentation The patient, a man in his 40s with end-stage heart failure owing to non-ischemic dilated cardiomyopathy, underwent LVAD implantation and warfarin was started on postoperative day 1. He started to use LVAD@home to manage warfarin therapy after discharge (postoperative day 47). He sent his data to care providers daily. By using this system, the pharmacist observed his signs of reduced dietary intake 179?days after discharge, and after consulting the physician, told the patient to change the timing of the next measurement earlier than usual. On the next day, the prothrombin time-international normalized ratio increased from 2.0 to 3.0, and thus the dose was decreased by 0.5?mg. Four patients used this system to monitor warfarin therapy from October 2015 to March 2018. In these patients, the time in therapeutic range was 90.1?±?1.3, which was higher than that observed in previous studies. Additionally, there were no thromboembolic events or bleeding events. Conclusions The cloud-based home management system can be applied to share real-time patient information of factors, including dietary intake that interact with warfarin. It can help to improve long-term anticoagulation outcomes in patients implanted with LVAD.
机译：摘要背景植入左心室辅助装置（LVADS）的标准抗凝治疗包括华法林治疗。我们开发了一个基于云的家庭医学管理信息共享系统，名为LVAD @ Home。 LVAD @ Home System是一个旨在用于iPad平板电脑的应用程序。该系统能够实时在患者和护理提供者之间共享日常信息。在这项研究中，我们报告了使用该系统进行抗凝治疗的LVAD的门诊患者的病例。案例介绍患者，由于非缺血性扩张的心肌病，在术后第1天开始，他40岁的男人患有未缺血性扩张的心肌病，接受了LVAD植入和华法林。他开始在出院后使用LVAD @ HOME来管理华法林治疗（术后第47天）。他每天向照顾提供者发送数据。通过使用该系统，药剂师观察了他减少膳食摄入量的迹象179？出院后的天数，并在咨询医生后，告诉患者比平常更早地改变下一次测量的时间。在第二天，凝血酶原期 - 国际归一化比率从2.0增加到3.0，因此剂量减少0.5μmg。四名患者利用该系统从2015年10月到2018年10月监测Warfarin治疗。在这些患者中，治疗范围的时间为90.1？±1.3，其高于先前研究中观察到的时间。此外，没有血栓栓塞事件或出血事件。结论云的家庭管理系统可用于共享因素的实时患者信息，包括与华法林相互作用的膳食摄入量。它可以有助于改善植入LVAD的患者的长期抗凝结果。

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