Effects of pharmacists' interventions on patient outcomes in an HIV primary care clinic
Effects of pharmacists' interventions on patient outcomes in an HIV primary care clinic
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DOI：
10.2146/ajhp070048
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发表时间：
2007-12-15
影响因子：
2.7
通讯作者：
Louie, Stan G.
中科院分区：
文献类型：
--
作者：
March, Kristi;Mak, May;Louie, Stan G.
目的。研究了药剂师干预对HIV初级保健门诊患者预后的影响。所有研究参与者都被推荐到2003年11月1日至2004年9月30日期间在县级艾滋病毒初级保健诊所由药剂师管理的药物优化诊所(DOC)。如果患者年满18岁或以上，并知情同意参与研究，他们就有资格参与研究。药剂师的干预措施被归类为：患者教育、添加药物、调整剂量、停止服药和解释病毒耐药性测试。在研究期间，还测量了基线CD4+T淋巴细胞计数和病毒载量的变化。与高效抗逆转录病毒治疗相关的毒性被记录下来，并从0到4分，0分表示没有毒性，4分表示严重毒性。研究参与者使用标准化调查来衡量他们自己与健康相关的生活质量。用t检验和方差分析分析CD4+淋巴细胞计数和病毒载量的变化。毒性分级采用Wilcoxon符号等级检验。共有34名患者完成了这项研究。药剂师总共进行了253次干预，其中大部分被归类为患者教育。在研究期间(p<；0.0002)，平均cd4+淋巴细胞计数比基线水平增加了54.78个/mm(3)。在研究期间，循环病毒载量的平均S.D.减少量为1.02log(10)拷贝/毫升(p<；0.004)。在DOC由药剂师管理的HIV感染患者在CD4+淋巴细胞计数、病毒载量和药物相关毒性方面较基线有显著改善。
Purpose. The effects of pharmacists' interventions on patient outcomes in an HIV primary care clinic were studied.Methods. All study participants were referred to a pharmacist-managed drug optimization clinic (DOC) in a county-based HIV primary care clinic between November 1, 2003, and September 30, 2004. Patients were eligible for study participation if they were 18 years of age or older and gave informed consent to participate. Pharmacists' interventions were categorized as follows: patient education, addition of a medication, dosage adjustment, discontinuation of a medication, and interpretation of viral-resistance tests. Changes in baseline CD4+ T-lymphocyte counts and viral load were also measured over the study period. Toxicities related to highly active antiretroviral therapy were recorded and graded from 0 to 4, with 0 indicating no toxicity and 4 indicating severe toxicity. Study participants used a standardized survey to measure their own health-related quality of life. Changes in CD4+ lymphocyte counts and viral load were analyzed using Student's t test and analysis of variance. Toxicity grades were analyzed using the Wilcoxon signed-rank test.Results. A total of 34 patients completed the study. Pharmacists made a total of 253 interventions, most of which were categorized as patient education. The mean CD4+ lymphocyte count increased from baseline levels by 54 78 cells/mm(3) over the study period (p < 0.0002). The mean S.D. reduction in circulating viral load over the study period was 1.02 log(10) copies/mL (p < 0.004).Conclusion. HIV-infected patients who were managed by pharmacists in a DOC demonstrated significant improvement from baseline in their CD4+ lymphocyte counts, viral loads, and drug-related toxicities.