Abstract：
Patients receiving biologic therapy for inflammatory bowel disease (IBD) require routine laboratory monitoring to ensure the safety and efficacy of therapy. The purpose of this quality improvement project was to evaluate the implementation of a dashboard to prevent treatment gaps by prospectively identifying patients with IBD and outdated laboratory results receiving biologics.
We performed a pre/post analysis of dashboard implementation to assess the number of patients with overdue laboratory work resulting in treatment gaps. The dashboard combined data from the electronic health record (EHR) and pharmacy claims database to identify patients on a biologic with laboratory tests (white blood cell count, liver transaminases, C-reactive protein, and erythrocyte sedimentation rate) completed 5 or more months ago and/or a tuberculosis screen completed 11 or more months ago. After implementation, specialty pharmacists reviewed the dashboard and communicated via EHR if a new prescription and laboratory tests were needed. Messages were sent 4 weeks in advance of the next refill-eligible date. Mixed methods were used for analysis of qualitative data, including surveys, and quantitative data, assessing treatment gap length.
A total of 40 patients who had outdated laboratory values and required a new prescription (15 before dashboard implementation and 25 after implementation) were included in the analysis. The frequency of a treatment gap decreased from 80% (n = 12) in the preimplementation phase to 32% (n = 8) in the postimplementation phase. The median gap length was shorter after dashboard implementation, decreasing from 21 days (range, 3-97 days) to 11 days (range, 2-23 days).
Utilization of a quality measures dashboard decreased treatment gaps in patients with IBD receiving biologic therapy. Integrated specialty pharmacists are uniquely positioned to monitor adherence to laboratory monitoring parameters for patients on biologics.
We performed a pre/post analysis of dashboard implementation to assess the number of patients with overdue laboratory work resulting in treatment gaps. The dashboard combined data from the electronic health record (EHR) and pharmacy claims database to identify patients on a biologic with laboratory tests (white blood cell count, liver transaminases, C-reactive protein, and erythrocyte sedimentation rate) completed 5 or more months ago and/or a tuberculosis screen completed 11 or more months ago. After implementation, specialty pharmacists reviewed the dashboard and communicated via EHR if a new prescription and laboratory tests were needed. Messages were sent 4 weeks in advance of the next refill-eligible date. Mixed methods were used for analysis of qualitative data, including surveys, and quantitative data, assessing treatment gap length.
A total of 40 patients who had outdated laboratory values and required a new prescription (15 before dashboard implementation and 25 after implementation) were included in the analysis. The frequency of a treatment gap decreased from 80% (n = 12) in the preimplementation phase to 32% (n = 8) in the postimplementation phase. The median gap length was shorter after dashboard implementation, decreasing from 21 days (range, 3-97 days) to 11 days (range, 2-23 days).
Utilization of a quality measures dashboard decreased treatment gaps in patients with IBD receiving biologic therapy. Integrated specialty pharmacists are uniquely positioned to monitor adherence to laboratory monitoring parameters for patients on biologics.
摘要：
结论：为了加快与COVID-19大流行有关的文章的发表，AJHP将在接受后尽快在网上发布这些手稿。接受的手稿经过同行评审和复制编辑，但在技术格式化和作者打样之前在线发布。这些手稿不是记录的最终版本，将在以后替换为最终文章（按照AJHP样式格式化并由作者证明）。
目的：接受炎症性肠病（IBD）生物治疗的患者需要常规实验室监测，以确保治疗的安全性和有效性。此质量改进项目的目的是评估仪表板的实施情况，以通过前瞻性地识别IBD患者和过时的生物制剂实验室结果来防止治疗差距。
方法：我们对仪表板实施进行了前/后分析，以评估逾期实验室工作导致治疗差距的患者人数。仪表板结合了来自电子健康记录（EHR）和药房索赔数据库的数据，以通过实验室测试（白细胞计数，肝脏转氨酶水平，C反应蛋白水平,和红细胞沉降率）在5个月或更长时间前完成和/或在11个月或更长时间前完成结核病筛查。实施后，如果需要新的处方和实验室检查,专业药剂师会查看仪表板并通过EHR进行沟通.在下一个可再填充的日期之前4周发送消息。采用混合方法对定性数据进行分析，包括调查,和定量数据，评估治疗间隙长度。
结果：我们包括实施前的15例患者和实施后的25例患者。治疗间隙的频率从实施前阶段的80％（n=12）下降到实施后阶段的32％（n=8）。实施后的中位间隙长度比实施前短，从21天减少(范围，3-97天）至11天（范围，2-23天）。
结论：使用质量测量仪表板减少了IBD患者在生物治疗方面的治疗差距。综合专业药剂师处于独特的位置，可以监测生物制剂患者对实验室监测参数的遵守情况。
目的：接受炎症性肠病（IBD）生物治疗的患者需要常规实验室监测，以确保治疗的安全性和有效性。此质量改进项目的目的是评估仪表板的实施情况，以通过前瞻性地识别IBD患者和过时的生物制剂实验室结果来防止治疗差距。
方法：我们对仪表板实施进行了前/后分析，以评估逾期实验室工作导致治疗差距的患者人数。仪表板结合了来自电子健康记录（EHR）和药房索赔数据库的数据，以通过实验室测试（白细胞计数，肝脏转氨酶水平，C反应蛋白水平,和红细胞沉降率）在5个月或更长时间前完成和/或在11个月或更长时间前完成结核病筛查。实施后，如果需要新的处方和实验室检查,专业药剂师会查看仪表板并通过EHR进行沟通.在下一个可再填充的日期之前4周发送消息。采用混合方法对定性数据进行分析，包括调查,和定量数据，评估治疗间隙长度。
结果：我们包括实施前的15例患者和实施后的25例患者。治疗间隙的频率从实施前阶段的80％（n=12）下降到实施后阶段的32％（n=8）。实施后的中位间隙长度比实施前短，从21天减少(范围，3-97天）至11天（范围，2-23天）。
结论：使用质量测量仪表板减少了IBD患者在生物治疗方面的治疗差距。综合专业药剂师处于独特的位置，可以监测生物制剂患者对实验室监测参数的遵守情况。
