Pharmacists as members of an interdisciplinary pulmonary embolism response team.
Pharmacists as members of an interdisciplinary pulmonary embolism response team.
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DOI：
10.1002/jac5.1569
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发表时间：
2022-04
期刊：
影响因子：
--
通讯作者：
Cameron, Scott J.
中科院分区：
文献类型：
--
作者：
Groth, Christine M.;Acquisto, Nicole M.;Wright, Colin;Marinescu, Mark;McNitt, Scott;Goldenberg, Ilan;Cameron, Scott J.
肺栓塞反应小组（PERT）旨在协助诊断、风险分层和管理中高危肺栓塞（PE），并已被证明可降低90天死亡率。药剂师在PERT中的作用没有很好的定义。描述药剂师作为PERT成员的角色，并确定药剂师是否可以改善抗凝时间，并促进使用低分子量肝素（LMWH）代替普通肝素（UFH）。一项在2014年1月至2020年5月期间发生大面积或亚大面积PE的成人患者中进行的回顾性、观察性研究。对PERT应答期间的患者人口统计学、临床变量、抗凝治疗/时间安排和药剂师活动进行了评价。患者被分为三组进行比较（前PERT与后PERT与药剂师与后PERT没有药剂师）。连续和分类数据分别采用Wilcoxon秩和或Kruskal-Wallis检验和卡方分析。共纳入573例患者（平均年龄63.2 ± 15.6岁，54%为男性，78%为次巨大PE）; PERT前组137例，PERT后组436例。在PERT后组中，305例患者（70%）有药剂师作为PERT成员，其中222例（73%）有记录的药物治疗相关干预/活动。大多数（n = 178，58%）涉及药剂师促进抗凝剂/溶栓剂的订购/给药。在PERT后组中，从诊断到抗凝治疗的中位时间显著缩短（PERT前：104分钟[IQR 124.5]，有药剂师的PERT后：63分钟[IQR 84]，无药剂师的PERT后：75.5分钟[IQR 113]，P = 0.0001）。当有药剂师参与与没有药剂师参与时，PERT后组中接受LMWH的患者多于UFH（69.5% vs 53.3%，P = 0.0019），大出血事件减少（PERT前：14.6%，有药剂师的PERT后：4.6%，没有药剂师的PERT后：9.9%，P = 0.0013）药剂师在PERT中发挥积极作用，他们的参与与更短的诊断到抗凝时间，增加LMWH的使用和更少的大出血事件相关。
Pulmonary embolism response teams (PERTs) were developed to assist with diagnosis, risk stratification, and management of intermediate and high-risk pulmonary embolism (PE) and have been shown to reduce 90-day mortality. The pharmacist’s role on the PERT is not well defined. Describe the pharmacist’s role as a PERT member and determine if pharmacists can improve time to anticoagulation and promote use of low molecular weight heparin (LMWH) instead of unfractionated heparin (UFH). A retrospective, observational study of adult patients with massive or submassive PE between January 2014 and May 2020. Patient demographics, clinical variables, anticoagulation treatment/timing, and pharmacist activities during PERT response were evaluated. Patients were divided into three groups for comparisons (pre-PERT vs post-PERT with a pharmacist vs post-PERT without a pharmacist). Wilcoxon rank-sum or Kruskal-Wallis test and chi-squared analysis were used for continuous and categorical data, respectively. A total of 573 patients were included (mean age 63.2 ± 15.6 years, 54% male, 78% submassive PE); 137 in the pre-PERT and 436 in the post-PERT groups. Within the post-PERT group, 305 patients (70%) had a pharmacist as a member of the PERT, of which 222 (73%) had a documented pharmacotherapy-related intervention/activity. Most (n = 178, 58%) involved a pharmacist facilitating ordering/administration of an anticoagulant/thrombolytic. Median time from diagnosis to anticoagulation was significantly reduced in the post-PERT groups (pre-PERT: 104 minutes [IQR 124.5], post-PERT with a pharmacist: 63 minutes [IQR 84], post-PERT without a pharmacist: 75.5 minutes [IQR 113], P = .0001). More patients in the post-PERT groups received LMWH compared to UFH when a pharmacist was involved vs without a pharmacist (69.5% vs 53.3%, P = .0019) and major bleeding events were reduced (pre-PERT: 14.6%, post-PERT with a pharmacist: 4.6%, and post-PERT without a pharmacist: 9.9%, P = .0013) Pharmacists have an active role on the PERT and their involvement was associated with a shorter diagnosis to anticoagulation time, increased LMWH use, and fewer major bleeding events.
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多学科肺栓塞反应团队对患者死亡率的影响。
DOI：
10.1016/j.amjcard.2021.08.066
发表时间：
2021-12-15
期刊：
The American journal of cardiology
影响因子：
--
作者：
Wright C;Goldenberg I;Schleede S;McNitt S;Gosev I;Elbadawi A;Pietropaoli A;Barrus B;Chen YL;Mazzillo J;Acquisto NM;Van Galen J;Hamer A;Marinescu M;Delehanty J;Cameron SJ
通讯作者：
Cameron SJ
影响因子：
1.5
作者：
Gosser, Rena A.;Arndt, Richard F.;Dang, Cathyyen H.
通讯作者：
Dang, Cathyyen H.
影响因子：
4.1
作者：
MacLaren, Robert;Bond, C. A.
通讯作者：
Bond, C. A.
影响因子：
3.7
作者：
Soh, Sarah;Kim, Jeong Min;Na, Sungwon
通讯作者：
Na, Sungwon
影响因子：
39.3
作者：
Konstantinides, Stavros V.;Torbicki, Adam;Zompatori, Maurizio
通讯作者：
Zompatori, Maurizio