Impact of a pharmacist intervention on DOAC knowledge and satisfaction in ambulatory patients.
Impact of a pharmacist intervention on DOAC knowledge and satisfaction in ambulatory patients.
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药剂师干预对门诊患者 DOAC 知识和满意度的影响。
DOI：
10.1007/s11239-022-02743-0
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发表时间：
2023
影响因子：
4
通讯作者：
Mazor,KathleenM
中科院分区：
文献类型：
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作者：
Pham,Thu;Patel,Parth;Mbusa,Daniel;Kapoor,Alok;Crawford,Sybil;Sadiq,Hammad;Rampam,Sanjeev;Wagner,Joann;Gurwitz,JerryH;Mazor,KathleenM
在门诊护理环境中，对高风险药物（如直接口服抗凝剂（DOAC））的患者教育有限。临床药剂师具有独特的能力来对患者进行有关DOACS的教育，但在患者教育和满意度经常被忽视的环境中，临床药剂师很少与患者互动。最近，抗凝论坛批准了一份清单（DOAC清单），以指导和教育患者开始或恢复DOAC。我们评估了对知识和满意度的干预框架周围的检查表的影响。随机临床试验。在门诊环境（办公室、急诊室或短期住院）中开始DOAC或在挫折（出血、卒中或短暂性脑缺血发作）后恢复DOAC的门诊患者。在3个月内进行3次教育性临床药剂师远程访问，通过热线与药剂师联系，并与连续性提供者协调。来自15项DOAC相关问卷的患者知识评分和来自简化版杜克抗凝满意度调查（DASS）的满意度评分。在561名随机化患者中，436名完成了我们的随访调查。233名干预患者与203名对照患者的知识得分相似（正确率分别为63.7%和62.2%）。7分Likert量表的满意度评分几乎相同（6.24和6.22）。我们的药剂师主导的干预框架周围的DOAC清单对知识和满意度的影响不大。干预结束和完成随访问卷之间的延迟可能掩盖了早期经历的益处。可能需要更多的强化教育或策略，而不是基于电话的咨询，以产生持续的知识。TRN：NCT 04068727回顾性登记于2019年8月22日。
Patient education of high-risk medications such as direct oral anticoagulants (DOACs) is limited in ambulatory care settings. Clinical pharmacists are uniquely equipped to educate patients about DOACS but seldom interact with patients in those settings where patient education and satisfaction are often overlooked. Recently, the Anticoagulation Forum endorsed a checklist (DOAC Checklist) to guide and educate patients initiating or resuming DOACs. We assessed the impact on knowledge and satisfaction of an intervention framed around the checklist. Randomized clinical trial. Ambulatory patients starting a DOAC or resuming one after setback (bleeding, stroke, or transient ischemic attack) in an ambulatory setting (office, emergency department, or short stay hospitalization). Three educational clinical pharmacist tele-visits, hotline access to the pharmacist, and coordination with continuity providers in 3 months. Patient knowledge scores from a 15-item DOAC-related questionnaire and satisfaction scores from an abbreviated version of the Duke Anticoagulation Satisfaction Survey (DASS). Of 561 randomized patients, 436 completed our follow-up surveys. Knowledge scores were similar for the 233 intervention patients vs. 203 control patients (63.7% vs 62.2% correct). Satisfaction scores on the 7-point Likert scale were virtually identical (6.24 and 6.22). Our pharmacist-led intervention framed around the DOAC checklist had little impact on knowledge and satisfaction. Delays between intervention end and completion of the follow-up questionnaires may have obscured benefits experienced earlier. More intensive education or strategies other than telephone-based consultation may be required to produce sustained knowledge.TRN: NCT04068727 retrospectively registered on August 22, 2019.