Comparative effectiveness of pharmacist care delivery models for hepatitis C clinics.
Comparative effectiveness of pharmacist care delivery models for hepatitis C clinics.
复制标题
丙型肝炎诊所药剂师护理服务模式的比较有效性。
DOI：
10.1093/ajhp/zxz034
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Berard-Collins,Christine
中科院分区：
文献类型：
--
作者：
Naidjate,SafiyaS;Zullo,AndrewR;Dapaah-Afriyie,Ruth;Hersey,MichelleL;Marshall,BrandonDL;Winkler,RichelleManalang;Berard-Collins,Christine
目的为丙型肝炎病毒（HCV）感染患者提供服务的最佳医疗服务模式尚不清楚。药剂师的参与可能是最佳丙型肝炎病毒护理提供的关键组成部分。我们比较了药剂师管理的HCV诊所和药剂师辅助的HCV诊所的有效性。方法：本回顾性队列研究使用2015年1月至2017年6月在单一卫生系统内药剂师管理诊所或药剂师辅助诊所开始HCV治疗的≥18岁患者的电子健康记录数据。结果包括治疗完成，治疗完成后12周的持续病毒学反应（SVR-12），以及在机构专业药房直接作用抗病毒药物的分配。采用治疗加权逆概率（IPTW） logistic回归模型比较两种临床模型的结果。结果共有127例患者开始了HCV治疗，其中64例患者来自药师管理的诊所，63例患者来自药师辅助的诊所。该队列的平均年龄为55岁，51%为男性，68%为白人。在IPTW分析中，在治疗完成度（优势比[OR]， 1.1； 95%可信区间[CI]， 0.1-13.8;p= 0.93）、12个月时实现持续病毒学应答（SVR-12） （OR, 1.0; 95% CI, 0.2-4.5;p= 0.62）或使用基于机构的专业药房（OR, 0.6; 95% CI, 0.2-1.7;p= 0.33）方面，药剂师管理的诊所和药剂师辅助的诊所之间没有差异。结论在药师管理的HCV诊所和药师辅助的HCV诊所接受治疗的患者的预后无显著差异。鉴于两组患者均达到SVR-12的频率，药剂师管理和药剂师辅助的临床模式可能是提供HCV门诊治疗的合理选择。
PurposeThe optimal health care delivery models for providing services to patients with infections caused by hepatitis C virus (HCV) remain unknown. Pharmacist involvement may be a key component of optimal HCV care delivery. We examined the comparative effectiveness of a pharmacist-managed HCV clinic versus a pharmacist-assisted HCV clinic.MethodsThis retrospective cohort study used electronic health record data on patients ≥18 years old initiating HCV treatment at a pharmacist-managed clinic or a pharmacist-assisted clinic within a single health-system between January 2015 and June 2017. Outcomes included treatment completion, sustained virologic response 12 weeks following treatment completion (SVR-12), and dispensation of direct-acting antiviral agents at the institution-based specialty pharmacy. Inverse probability of treatment-weighted (IPTW) logistic regression models were used to compare outcomes between the 2 clinic models.ResultsA total of 127 patients initiated HCV treatment therapy: 64 patients from the pharmacist-managed clinic and 63 patients from the pharmacist-assisted clinic. The cohort had a mean age of 55 years, was 51% male, and 68% white. In IPTW analyses, there was no difference in treatment completion (odds ratio [OR], 1.1; 95% confidence interval [CI], 0.1–13.8;p= 0.93), achievement of sustained virologic response at 12 months (SVR-12) (OR, 1.0; 95% CI, 0.2–4.5;p= 0.62), or use of institution-based specialty pharmacy (OR, 0.6; 95% CI, 0.2–1.7;p= 0.33) between pharmacist-managed and pharmacist-assisted clinics.ConclusionThere were no significant differences in outcomes between patients receiving care at the pharmacist-managed HCV clinic and the pharmacist-assisted clinic. Given the frequency of SVR-12 achieved in both groups, both pharmacist-managed and pharmacist-assisted clinic models may be reasonable alternatives for providing outpatient HCV care.
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影响因子：
4.3
作者：
Langness JA;Nguyen M;Wieland A;Everson GT;Kiser JJ
通讯作者：
Kiser JJ
影响因子：
39.2
作者：
Denniston MM;Jiles RB;Drobeniuc J;Klevens RM;Ward JW;McQuillan GM;Holmberg SD
通讯作者：
Holmberg SD
DOI：
10.7326/0003-4819-127-8_part_2-199710151-00064
发表时间：
1997-10-15
影响因子：
39.2
作者：
Rubin, DB
通讯作者：
Rubin, DB
影响因子：
1.3
作者：
Mikolas, Lena A.;Jacques, Kimberly;Mambourg, Scott E.
通讯作者：
Mambourg, Scott E.
影响因子：
5
作者：
Cole, Stephen R.;Hernan, Miguel A.
通讯作者：
Hernan, Miguel A.