Clinical pharmacy specialists providing consistent comprehensive medication management with increased efficiency through telemedicine during the COVID19 pandemic
Clinical pharmacy specialists providing consistent comprehensive medication management with increased efficiency through telemedicine during the COVID19 pandemic
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DOI：
10.1002/jac5.1494
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发表时间：
2021-07-11
期刊：
影响因子：
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通讯作者：
Lamb, Kristen
中科院分区：
文献类型：
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作者：
Thomas, Ashley M.;Baker, Jennifer W.;Lamb, Kristen
退伍军人事务部（VA）一直处于利用临床药学专家（CPS）在患者对齐护理团队（PACT）中的技能的最前沿，以改善患者护理结果并为退伍军人创造机会。随着2019冠状病毒病（COVID 19）的不幸到来，PACT CPS有责任加速扩展远程医疗服务。本质量改进分析的目的是比较CPS效率以及一些客观的患者指标，以评估护理质量的变化。这是第一项比较CPS在VA pre-COVID 19和COVID 19大流行期间的护理效率和质量的研究。方法回顾性分析2019年3月10日至2019年11月30日和2020年3月10日至2020年11月30日PACT CPS综合用药管理。数据点集中在诊所就诊、患者对预约的责任、疾病状态扩展和疾病状态管理的标志物。鉴于糖尿病和高血压是大多数PACT CPS管理的主要疾病状态，该研究还评估了两个队列之间血红蛋白A1c（HbA1c）和血压（BP）的变化。使用GraphPad软件或Microsoft Excel分析数据。学生T检验用于连续数据，卡方或Fisher Exact用于标称数据。结果2020年PACT CPS就诊总人次增长32%，独特患者数增长12%。电话和直接面向消费者（DCT）的视频访问量在统计上显著增加。2019年至2020年期间，未入住率及取消率显著下降。两个研究组之间HbA1c或平均血压的平均变化没有差异。结论：当PACT CPS服务从主要的面对面访问过渡到所有的虚拟护理时，护理的一致性得到改善，护理质量没有受到影响。
Introduction The Veterans Affairs (VA) has been at the forefront of harnessing the skills of clinical pharmacy specialists (CPS) in patient-aligned care teams (PACT) to improve patient care outcomes and create access for veterans. With the unfortunate arrival of Coronavirus disease 2019 (COVID19), PACT CPS were duty-bound to expand telehealth services at an accelerated rate. The purpose of this quality improvement analysis is to compare CPS efficiency as well as some objective patient metrics to assess for a change in the quality of care. This is the first study to compare the efficiency and quality of care by CPS in the VA pre-COVID19 and during the COVID19 pandemic. Methods This is a retrospective review of PACT CPS comprehensive medication management from 3/10/19 to 11/30/19 and 3/10/20 to 11/30/20. Data points focused on clinic encounters, patient accountability to appointments, disease state expansion, and markers of disease-state management. Given diabetes and hypertension are the main disease states managed by most PACT CPS', the study evaluated changes in hemoglobin A1c (HbA1c) and blood pressure (BP) between the two cohorts as well. Data were analyzed using GraphPad Software or Microsoft Excel. A student T-test was used for continuous data and Chi-squared or Fishers Exact for nominal data. Results The total number of PACT CPS encounters increased 32% in 2020, and the number of unique patients increased by 12%. There were a statistically significant increase in telephone and direct-to-consumer (DCT) video visits. The rates of no shows and cancellations significantly decreased between 2019 and 2020. There was no difference in the average change in HbA1c or average blood pressure between the two study groups. Conclusions When PACT CPS services transitioned from primarily face-to-face visits to all virtual care, the consistency of care improved, and the quality of care was not compromised.