Influence of pharmacist intervention on prescribing of angiotensin-converting-enzyme inhibitors, angiotensin II-receptor blockers, and aspirin for diabetic patients
Influence of pharmacist intervention on prescribing of angiotensin-converting-enzyme inhibitors, angiotensin II-receptor blockers, and aspirin for diabetic patients
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DOI：
10.2146/ajhp090009
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发表时间：
2010-02-15
影响因子：
2.7
通讯作者：
Ryan, Mary
中科院分区：
文献类型：
--
作者：
LaMarr, Brandon;Valdez, Connie;Ryan, Mary
目的。评价药师干预对糖尿病患者血管紧张素转换酶(ACE)抑制剂、血管紧张素Ⅱ受体阻滞剂(ARB)和阿司匹林处方的影响。对在家庭医学诊所就诊的糖尿病患者进行了回顾性图表回顾。如果患者年龄在18-88岁之间，被诊断为1型或2型糖尿病，在2006年7月至2008年10月期间曾在家庭医学诊所就诊，并接受过药房服务机构的咨询，则纳入分析。按照美国糖尿病协会(ADA)指南的建议，在药剂师干预前后，对所有选定的图表进行审查，以评估ACE抑制剂、ARB和阿司匹林治疗的适当使用。典型的药剂师干预措施包括直接咨询处方医生和由药房人员进行治疗教育会议。所有患者在开具处方前均由药房人员进行会诊和评估。在药剂师干预之前，70名患者中有41名(59%)正在接受适当的ACE抑制剂或ARB治疗，而在71名患者中有24名(34%)正在接受ADA推荐的适当的阿司匹林治疗。经药师干预后，70例患者中有63例(90%)接受了适当的血管紧张素转换酶抑制剂或血管紧张素转换酶抑制剂治疗，71例患者中有48例(68%)接受了ADA推荐的适当的阿司匹林治疗(P<；0.0001)。初级保健环境中的药房干预计划与糖尿病患者对血管紧张素转换酶抑制剂或ARB治疗以及阿司匹林治疗的ADA指南依从性显著增加有关。
Purpose. The influence of pharmacist intervention on the prescribing of angiotensin-converting-enzyme (ACE) inhibitors, angiotensin II-receptor blockers (ARBs), and aspirin for patients with diabetes was evaluated.Methods. A retrospective chart review was performed for diabetic patients seen in a family medicine clinic. Patients were included in the analyses if they were 18-88 years old, had a diagnosis of type 1 or type 2 diabetes, had been seen in the family medicine clinic between July 2006 and October 2008, and had received a consultation by pharmacy services. All selected charts were reviewed to assess appropriate use of ACE inhibitor, ARB, and aspirin therapy, as recommended by American Diabetes Association (ADA) guidelines, before and after pharmacist intervention. Typical pharmacist interventions consisted of direct consultation with the prescriber and therapeutic education sessions conducted by pharmacy personnel. All patients were seen and evaluated by pharmacy personnel before meeting with the prescriber.Results. Before pharmacist intervention, 41 (59%) of 70 patients were receiving appropriate ACE inhibitor or ARB therapy and 24 (34%) of 71 patients were receiving appropriate aspirin therapy as recommended by ADA. After pharmacist intervention, 63 (90%) of 70 patients were receiving appropriate ACE inhibitor or ARB therapy and 48 (68%) of 71 patients were receiving appropriate aspirin therapy as recommended by ADA (p < 0.0001 for both differences).Conclusion. A pharmacy intervention program in a primary care setting was associated with a significant increase in prescriber adherence to ADA guidelines for ACE inhibitor or ARB therapy and for aspirin therapy in diabetic patients.