Enhanced Continuity of Pharmacy Care for Cardiovascular or Pulmonary Diseases

增强心血管或肺部疾病药房护理的连续性

基本信息

批准号：
7251609
负责人：
Barry L Carter
金额：
$ 71.26万
依托单位：
UNIVERSITY OF IOWA
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-06-01 至 2012-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7251609
关键词：
Accident and Emergency department Accreditation Address Adherence Admission activity Adverse event Area Beds Cardiovascular Diseases Cardiovascular system Caring Case Management Case Manager Clinical Collaborations Communication Communities Community Physician Confusion Continuity of Patient Care Control Groups Controlled Clinical Trials Data Diabetes Mellitus Drug usage Education Elderly Evaluation Event Goals Guidelines Healthcare Healthcare Systems Hospitalization Hospitals Information and Communication Theory Inpatients Intervention Joint Commission on Accreditation of Healthcare Organizations Joints Knowledge Link Lung diseases Medical Methods Modeling Numbers Office Visits Outcome Outpatients Patient Care Patient Education Patient Monitoring Patients Pharmaceutical Preparations Pharmacists Pharmacy facility Physicians Plant Roots Prevention Primary Care Physician Probability Problem Solving Prospective Studies Provider Quality of Care Randomized Range Recommendation Recording of previous events Research Research Personnel Risk Role Safety Sample Size Services Source System Telefacsimile Telephone Testing Time University Hospitals Visit base chronic care model cost effectiveness day follow-up hospital readmission improved member older patient patient safety prescription document prescription procedure prevent programs

项目摘要

DESCRIPTION (provided by applicant): Drugs used to treat cardiovascular or pulmonary diseases, or diabetes are the most frequent causes of hospitalizations and emergency department visits due to suboptimal therapy or adverse drug events (ADEs). The lack of communication and coordination between the inpatient setting and the community setting contributes to these problems. ADEs occur in 25% of ambulatory patients and may cause 17% of hospital admissions among the elderly. Expanded roles for pharmacists have been suggested to reduce ADEs. Previous studies that examined information transfer between inpatient and community pharmacists had small sample sizes, did not include the primary care physician, nor did they evaluate the effect of the communication on ADEs, hospitalizations or unscheduled visits. These information gaps in the research need to be addressed in order to identify optimal strategies to improve therapy and reduce ADEs. The primary objective of this application is to test whether providing a pharmacy case manager to: 1) reconcile medications on admission and discharge, 2) increase patient understanding, and 3) provide post-discharge follow-up of medication use, and 4) increasing communication of discharge medication plans to community physicians and pharmacists will reduce ADEs in patients with selected cardiovascular or pulmonary diseases or diabetes. This will be a randomized, prospective study to evaluate the impact of enhanced continuity of pharmacy care on appropriateness of therapy, ADEs, hospitalizations or unscheduled visits. Patients (n = 1000) admitted to the university hospital will be randomized to a control, minimal intervention or enhanced intervention group. For the enhanced intervention group, a hospital pharmacist case manager will provide: 1) an admission medication history, 2) a discharge summary and patient education, 3) transfer of discharge summary data to the community physician and pharmacist, 4) telephone follow-up 3-5 days post-discharge, and 5) communication and recommendations to the physician and pharmacist in the community. The minimal intervention group will receive: 1) the admission medication history, and 2) a discharge summary and education. The study will be one of the most comprehensive characterizations of ADEs and their prevention ever conducted. There is a high probability that this intervention can impact patient care by reducing the burden of ADEs in older patients who are at high risk for medication-related problems.

描述（由申请人提供）：用于治疗心血管或肺部疾病或糖尿病的药物是因治疗不理想或药物不良事件 (ADE) 导致住院和急诊就诊的最常见原因。住院环境和社区环境之间缺乏沟通和协调导致了这些问题。 25% 的门诊患者发生 ADE，并可能导致 17% 的老年人入院。建议扩大药剂师的作用以减少不良事件。先前检查住院患者和社区药剂师之间信息传递的研究样本量较小，不包括初级保健医生，也没有评估沟通对 ADE、住院或计划外就诊的影响。需要解决研究中的这些信息差距，以便确定改善治疗和减少 ADE 的最佳策略。此应用程序的主要目的是测试是否提供药房案例经理来：1) 协调入院和出院时的药物，2) 增加患者的理解，3) 提供出院后药物使用情况的跟踪，4) 增加向社区医生和药剂师传达出院用药计划将减少患有特定心血管疾病、肺部疾病或糖尿病的患者的 ADE。这将是一项随机、前瞻性研究，旨在评估加强药房护理的连续性对治疗、不良事件、住院或计划外就诊的适当性的影响。入住大学医院的患者 (n = 1000) 将被随机分配到对照组、最小干预组或强化干预组。对于强化干预组，医院药剂师病例经理将提供：1) 入院用药史，2) 出院小结和患者教育，3) 将出院小结数据传输给社区医生和药剂师，4) 电话随访出院后3-5天，以及5)与社区医生和药剂师的沟通和建议。最低限度干预组将收到：1) 入院用药史，2) 出院总结和教育。该研究将是迄今为止对 ADE 及其预防进行的最全面的表征之一。这种干预措施很有可能通过减轻药物相关问题高风险老年患者的 ADE 负担来影响患者护理。