دورية أكاديمية
Implementation and Preliminary Clinical Outcomes of a Pharmacist-managed Venous Thromboembolism Clinic for Patients Treated With Rivaroxaban Post Emergency Department Discharge.
| العنوان: | Implementation and Preliminary Clinical Outcomes of a Pharmacist-managed Venous Thromboembolism Clinic for Patients Treated With Rivaroxaban Post Emergency Department Discharge. |
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| المؤلفون: | DiRenzo BM; Department of Pharmacy, Eskenazi Health, Indianapolis, IN., Beam DM; Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN., Kline JA; Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN., Deodhar KS; Department of Pharmacy, Eskenazi Health, Indianapolis, IN., Weber ZA; Department of Pharmacy, Eskenazi Health, Indianapolis, IN., Davis CM; Department of Pharmacy, Eskenazi Health, Indianapolis, IN., Walroth TA; Department of Pharmacy, Eskenazi Health, Indianapolis, IN. |
| المصدر: | Academic emergency medicine : official journal of the Society for Academic Emergency Medicine [Acad Emerg Med] 2018 Jun; Vol. 25 (6), pp. 634-640. Date of Electronic Publication: 2017 Nov 23. |
| نوع المنشور: | Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wiley Country of Publication: United States NLM ID: 9418450 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1553-2712 (Electronic) Linking ISSN: 10696563 NLM ISO Abbreviation: Acad Emerg Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Hoboken, N.J. : Wiley Original Publication: Philadelphia, PA : Hanley & Belfus, c1993- |
| مواضيع طبية MeSH: | Ambulatory Care Facilities/*organization & administration , Anticoagulants/*administration & dosage , Pharmacists/*organization & administration , Rivaroxaban/*administration & dosage , Venous Thromboembolism/*drug therapy, Anticoagulants/adverse effects ; Anticoagulants/economics ; Anticoagulants/therapeutic use ; Case-Control Studies ; Emergency Service, Hospital/statistics & numerical data ; Female ; Hemorrhage/chemically induced ; Humans ; Male ; Medication Adherence ; Middle Aged ; Outcome Assessment, Health Care ; Retrospective Studies ; Rivaroxaban/adverse effects ; Rivaroxaban/economics ; Rivaroxaban/therapeutic use ; Venous Thromboembolism/prevention & control |
| مستخلص: | Objective: The objective was to describe the implementation, work flow, and differences in outcomes between a pharmacist-managed clinic for the outpatient treatment of venous thromboembolism (VTE) using a non-vitamin K oral anticoagulant versus care by a primary care provider (PCP). Methods: Patients in the studied health system that are diagnosed with low-risk VTE in the emergency department are often discharged without hospital admission. These patients are treated with a non-vitamin K oral anticoagulant and follow-up either in a pharmacist-managed VTE clinic or with their PCP. Pharmacists in the VTE clinic work independently under a collaborative practice agreement (CPA). An evaluation of 34 patients, 17 in each treatment arm, was conducted to compare the differences in treatment-related outcomes of rivaroxaban when managed by a pharmacist versus a PCP. Results: The primary endpoint was a 6-month composite of anticoagulation treatment-related complications that included a diagnosis of major bleeding, recurrent thromboembolism, or fatality due to either major bleeding or recurrent thromboembolism. Secondary endpoints included number of hospitalizations, adverse events, and medication adherence. There was no difference in the primary endpoint between groups with one occurrence of the composite endpoint in each treatment arm (p = 1.000), both of which were recurrent thromboembolic events. Medication adherence assessment was formally performed in eight patients in the pharmacist group versus no patients in the control group. No differences were seen among other secondary endpoints. Conclusions: The pharmacist-managed clinic is a novel expansion of clinical pharmacy services that treats patients with low-risk VTEs with rivaroxaban in the outpatient setting. The evaluation of outcomes provides support that pharmacist-managed care utilizing standardized protocols under a CPA may be as safe as care by a PCP. (© 2017 by the Society for Academic Emergency Medicine.) |
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| معلومات مُعتمدة: | K12 HL133310 United States HL NHLBI NIH HHS |
| المشرفين على المادة: | 0 (Anticoagulants) 9NDF7JZ4M3 (Rivaroxaban) |
| تواريخ الأحداث: | Date Created: 20170919 Date Completed: 20190909 Latest Revision: 20200325 |
| رمز التحديث: | 20240829 |
| مُعرف محوري في PubMed: | PMC7089614 |
| DOI: | 10.1111/acem.13311 |
| PMID: | 28921763 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1553-2712 |
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| DOI: | 10.1111/acem.13311 |