结论:为了加快文章的发表,AJHP在接受后尽快在线发布手稿。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:出院时处方抗生素使用时间过长是很常见的。由药剂师主导的抗菌药物管理计划过渡护理(ASPTOC)干预与改善出院处方有关。为了提高这项服务的可持续性,电子评分系统(ESS),其中包括ASPTOC电子变量,在电子病历中实施,以优先考虑药剂师的工作量。这项研究的目的是评估社区获得性肺炎(CAP)或慢性阻塞性肺疾病(COPD)患者的ESS中ASPTOC变量的实施情况。
方法:本机构审查委员会批准,回顾性准实验纳入2021年11月1日至2022年3月1日(干预前)和2022年11月1日至2023年3月1日(干预后)因CAP或COPD急性加重(下呼吸道感染)接受口服抗生素治疗的患者.主要终点为优化出院抗菌方案。需要至少194名患者的样本来实现80%的功率以检测优化治疗的频率的20%差异。多变量逻辑回归用于确定与优化方案相关的因素。
结果:在两个研究组中观察到相似的基线特征(两组n=100)。优化放电方案的频率从69%提高到82%(P=0.033)。药剂师完成的ASPTOC干预措施的百分比从4%增加到25%(P<0.001)。ASPTOC干预,女性性别,和COPD与优化的出院方案独立相关(调整后的比值比,分别为6.57、1.61和3.89;95%CI,分别为1.51-28.63、0.81-3.17和1.85-8.20)。
结论:启动ASPTOC变量后,优化的出院方案增加,ASPTOC干预完成.药剂师通过ESS使用ASPTOC变量可以帮助改善出院处方。
CONCLUSIONS: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.
OBJECTIVE: Prescribing excess antibiotic duration at hospital discharge is common. A pharmacist-led Antimicrobial Stewardship Program Transition of Care (ASP TOC) intervention was associated with improved discharge prescribing. To improve the sustainability of this service, an electronic scoring system (ESS), which included the ASP TOC electronic variable, was implemented in the electronic medical record to prioritize pharmacist workload. The purpose of this study was to evaluate the implementation of the ASP TOC variable in the ESS in patients with community-acquired pneumonia (CAP) or chronic obstructive pulmonary disease (COPD).
METHODS: This institutional review board-approved, retrospective quasi-experiment included patients discharged on oral antibiotics for CAP or COPD exacerbation (lower respiratory tract infection) from November 1, 2021, to March 1, 2022 (the preintervention period) and November 1, 2022, to March 1, 2023 (the postintervention period). The primary endpoint was optimized discharge antimicrobial regimen. A sample of at least 194 patients was required to achieve 80% power to detect a 20% difference in the frequency of optimized therapy. Multivariable logistic regression was used to identify factors associated with optimized regimens.
RESULTS: Similar baseline characteristics were observed in both study groups (n = 100 for both groups). The frequency of optimized discharge regimens improved from 69% to 82% (P = 0.033). The percentage of ASP TOC interventions documented as completed by a pharmacist increased from 4% to 25% (P < 0.001). ASP TOC intervention, female gender, and COPD were independently associated with an optimized discharge regimen (adjusted odds ratios, 6.57, 1.61, and 3.89, respectively; 95% CI, 1.51-28.63, 0.81-3.17, and 1.85-8.20, respectively).
CONCLUSIONS: After the launch of the ASP TOC variable, there was an increase in optimized discharge regimens and ASP TOC interventions completed. Pharmacists\' use of the ASP TOC variable through an ESS can aid in improving discharge prescribing.