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首页> 外文期刊>The Journal of pharmacy technology: jPT : official publication of the Association of Pharmacy Technicians >Comparison of Interventions Made in an Ambulatory Pharmacist-Managed Refill Model to Usual Physician Care
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Comparison of Interventions Made in an Ambulatory Pharmacist-Managed Refill Model to Usual Physician Care

机译：在通常的医生护理中对动态药剂师管理的再填充模型中的干预措施的比较

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Background: With the current practice model, there is less time for physicians to address refill authorization requests (RARs) while performing consistent quality care, which creates an opportunity for pharmacists to assist in refills. Currently, inadequate evidence is available to support this intervention. Objective: To compare the rate of medication management interventions (MMIs - drug therapy changes, laboratory monitoring ordered, or office visit scheduled) initiated by the pharmacist-managed authorization center (PMAC) to usual care. Methods: A retrospective, noninferiority study looked at 4000 RARs from 6 primary care centers from January 2016 through March 2017. The primary endpoint compared the rate of MMIs between PMAC and usual care. Noninferiority was concluded if the upper limit of the 95% CI of the difference in interventions was <2%. Secondary endpoints included total, type, and acceptance rate of PMAC recommendations. Results: A total of 3830 patients were included, with 4732 medications requested (2183 reviewed by PMAC and 2549 by usual care). MMIs occurred in 153 medications within PMAC (7.0%) versus 90 for usual care (3.5%). The difference in total MMIs between PMAC and usual care was -3.5% (95% confidence interval = -4.8% to -2.2%). Medications reviewed by PMAC had significantly higher number of laboratory monitoring (P = .036) and scheduled appointments (P < .001). There were 294 PMAC recommendations (13.5%) with a 52.0% acceptance rate. Conclusion and Relevance: This study showed that PMAC was superior to usual care for reviewing RARs. There was a statistically significant improvement in medication monitoring and patient follow-up, supporting the idea of including a pharmacist in the decision making.
机译：背景：随着当前的实践模型，医生在执行一致的质量保健时，医生可以解决重新填充授权请求（RARS）的时间，这为药剂师提供了协助补充的机会。目前，证据不足以支持这种干预。目的：比较药剂师管理授权中心（PMAC）发起的药物管理干预（MMIS - 药物治疗变更，实验室监测订购或办公室访问计划）对通常的关怀。方法：从2016年1月到2017年3月的6个初级保健中心，备受回顾性的，非闭合性研究。主要终点与PMAC和通常护理之间的MMIS比较了MMIS。结论了非歧视差异的95％CI的上限<2％，则结束了不合理性。辅助端点包括总，类型和PMAC建议的接受率。结果：共有3830名患者，要求4732名药物（2183次由PMAC和2549审查）。 MMIS在PMAC（7.0％）内的153个药物中发生，而90次常用护理（3.5％）。 PMAC和常规护理之间的总MMIS的差异为-3.5％（95％置信区间= -4.8％至-2.2％）。 PMAC审查的药物数量大幅增加了实验室监测（P = .036）和预定的约会（P <.001）。有294项PMAC建议（13.5％），接受率为52.0％。结论和相关性：本研究表明，PMAC优于常规护理案件。药物监测和患者随访有统计学意义的改善，支持包括决策中的药剂师的想法。

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