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The role of clinical pharmacy anticoagulation services in direct oral anticoagulant monitoring.
临床药学抗凝服务在直接口服抗凝监测中的作用。
- 影响因子：2.56
- DOI：10.1007/s11239-020-02064-0
- 作者列表："Jones AE","King JB","Kim K","Witt DM
- 发表时间：2020-02-21
Abstract
:The role of dedicated anticoagulation management services (AMS) for patients receiving direct oral anticoagulant (DOAC) therapy is unclear. The objective of our study was to describe DOAC management in patients who were and were not managed by an AMS. We conducted a retrospective cohort study among patients with atrial fibrillation at the University of Utah Health (UUH) who received DOAC therapy between January 2013 and June 2016. Patients in the AMS group were managed by a pharmacist-led AMS whereas those in the non-AMS group were managed by other providers. The number and type of provider encounters and interventions related to DOAC therapy and a composite endpoint of thromboembolism, bleeding, and all-cause mortality were recorded. Overall, 90 and 370 patients were managed in the AMS and non-AMS groups, respectively. AMS group patients had greater chronic disease burden as measured by the Charlson comorbidity index. AMS group patients had more frequent DOAC-related encounters than non-AMS group patients but both groups had similar DOAC therapy intervention rates. Over half of patients in the AMS group received potentially duplicative interventions from their regular clinicians. The composite endpoint occurred in 18.9% and 13.5% of AMS and non-AMS group patients, respectively (p = 0.29). Patients managed by AMS providers were more complex and had more frequent encounters regarding their DOAC therapy than those managed by non-AMS providers. However, there was evidence of duplicative DOAC therapy management efforts. No difference between AMS and non-AMS groups in the composite clinical endpoint was detected.
摘要
: 对于接受直接口服抗凝药 (DOAC) 治疗的患者，专门的抗凝管理服务 (AMS) 的作用尚不清楚。我们研究的目的是描述由 AMS 管理和未管理的患者的 DOAC 管理。我们在 2013年1月至 2016年6月期间接受 DOAC 治疗的犹他健康大学 (UUH) 房颤患者中进行了一项回顾性队列研究。AMS 组的患者由药剂师领导的 AMS 管理，而非 AMS 组的患者由其他提供者管理。记录与 DOAC 治疗相关的提供者遭遇和干预的数量和类型以及血栓栓塞、出血和全因死亡率的复合终点。总体而言，AMS 组和非 AMS 组分别管理了 90 例和 370 例患者。通过 Charlson 合并症指数测量，AMS 组患者的慢性病负担更大。AMS 组患者比非 AMS 组患者有更频繁的 DOAC 相关遭遇，但两组的 DOAC 治疗干预率相似。AMS 组中超过一半的患者接受了来自其常规临床医生的潜在重复干预。AMS 组和非 AMS 组患者的复合终点发生率分别为 18.9% 和 13.5% (p = 0.29)。与非 AMS 提供者管理的患者相比，AMS 提供者管理的患者更复杂，更频繁地遇到他们的 DOAC 治疗。然而，有证据表明 DOAC 治疗管理工作存在重复。未检测到 AMS 和非 AMS 组在复合临床终点方面的差异。
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影响因子：3.75
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影响因子：1.65
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DOI：10.1007/s10840-019-00700-1
作者列表：["Takamiya T","Nitta J","Inaba O","Sato A","Ikenouchi T","Murata K","Inamura Y","Takahashi Y","Goya M","Hirao K"]
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