Abstract：
Background: Limited evidence exists regarding pharmacist involvement and impact in inflammatory bowel disease (IBD) interdisciplinary clinic care models. The purpose is to describe pharmacist utilization in an interdisciplinary IBD clinic and evaluate clinical impact on patient quality of life. Methods: This was a retrospective cohort study comparing outcomes in patients with Crohn\'s disease initiated on therapy when the implementation of pharmacy services began (Early Phase) to the expansion of pharmacy services (Recent Phase). The primary outcome compared the proportion of patients referred to a pharmacist and those achieving a Harvey-Bradshaw Index (HBI) reduction of ≥3 points after therapy initiation. Results: 50 patients were included in the Early Phase and 43 patients in the Recent Phase. Utilization in pharmacy referrals increased from 48% (n = 24) in the Early Phase to 72% (n = 31) in the Recent Phase (P = 0.03). The proportion of patients achieving a HBI reduction of ≥3 points increased from 35% (n = 14) in the Early Phase to 51% (n = 18) in the Recent Phase (P = 0.23). Results also found a greater proportion of patients remaining steroid free in the Recent Phase compared to the Early Phase (50% vs 63%; P = 0.01) and C-reactive protein (CRP) improved significantly in the Recent Phase (-11) compared to (-3) in the Early Phase (P = 0.006). Conclusion: The utilization of pharmacists in an interdisciplinary IBD clinic increased and showed to impact patient care through improving symptom relief as seen by the achievement rate of the HBI score reduction, reducing steroid use after therapy initiation, and making clinically significant interventions.
摘要：
背景：关于药剂师参与和影响炎症性肠病（IBD）跨学科临床护理模式的证据有限。目的是描述跨学科IBD诊所的药剂师使用情况，并评估对患者生活质量的临床影响。方法：这是一项回顾性队列研究，比较了从开始实施药学服务（早期）到扩展药学服务（最近阶段）开始治疗的克罗恩病患者的结局。主要结果比较了转诊给药剂师的患者比例和治疗开始后达到Harvey-Bradshaw指数（HBI）降低≥3分的患者比例。结果：早期阶段有50例患者，最近阶段有43例患者。药房转诊的利用率从早期阶段的48％（n=24）增加到最近阶段的72％（n=31）（P=0.03）。实现HBI降低≥3分的患者比例从早期阶段的35％（n=14）增加到最近阶段的51％（n=18）（P=0.23）。结果还发现，与早期阶段相比，在最近阶段保持无类固醇状态的患者比例更高（50％vs63％；P=0.01），并且C反应蛋白（CRP）在最近阶段（-11）显着改善早期阶段（-3）（P=0.006）。结论：跨学科IBD诊所中药剂师的使用增加，并显示出通过改善症状缓解来影响患者护理，如HBI评分降低的实现率所示，治疗开始后减少类固醇的使用，并进行临床重大干预。
