家里有药剂师吗?

面试官: 家里有药剂师吗? 使药剂师在初级保健设置的情况. 接下来是《大发娱乐》.

播音员: Examining the latest 研究 and telling you about the latest breakthroughs. 科学研究节目在范围上播出.

药剂师 & 初级护理

面试官: Most people don't think of 药剂师s as being involved with primary care at the clinic, but Dr. 凯莉·麦克亚当-马克思认为这种情况需要改变. She's the Associate Professor of Pharmacotherapy at the University of Utah. 所以有a的情况下 药剂师 in the primary care setting is not only better for the patient, but it also makes economic sense. 你对此做了一些研究. 你能谈谈这个吗?

这项研究

Dr. McAdam-Marx: We took a group of patients that had been treated in a primary care clinic that had access to a clinical 药剂师 and these 药剂师s were specifically focusing on patients with 糖尿病, II型糖尿病. 糖尿病患者需要服用很多药物, 不幸的是, 一般II型糖尿病患者没有得到最佳控制. So we had approximately 300 patients that had been followed by a clinical 药剂师 in the primary care setting and we compared those to about 400 patients in clinics that didn't have access to a 药剂师 at that time.

It's a service that's evolving in our University of Utah community clinic is at this point. 大发娱乐看看他们是如何 糖尿病 控制, 大发娱乐观察了他们的糖尿病控制情况, 由药剂师跟踪, 但大发娱乐也考虑了它们的成本, their total cost of care from the perspective of the University of Utah Health System.

还有大发娱乐的干预病人, 那些见过药剂师的病人和大发娱乐的对照病人, 随着时间的推移，成本增加了, 这并不一定出乎意料. 他们都是老年患者, they have complex health conditions and their costs are naturally going to tend to go up. But what we saw was that the patients who were followed by the 药剂师 had a much slower increase in cost than those who were not.

研究长度 & Cost

面试官: 随着时间的推移，你看了多长时间?

Dr. McAdam-Marx: 大发娱乐跟踪这些病人一年.

面试官: 而在成本上的差异，有多大的差异?

Dr. McAdam-Marx: 在对比病人中, 他们的成本在那一年里上升了, they were higher in the year after our baseline period by about $1200 per year. And then the comparison patients were closer to $200 increase per year.

面试官: 哦,哇.

Dr. McAdam-Marx: 所以这是实质性的. 是很困难的, 在很短的时间内, in a chronic disease to show an improvement like this so we were really excited with the results.

面试官: 所以他们有更少的并发症或者什么是反射? 成本降低的原因是什么?

Dr. McAdam-Marx: We looked at total cost, so all of their outpatient costs and inpatient cost, emergency visit costs. 大发娱乐发现，这些患者使用了更多的初级保健服务. They were going in and having follow-up visits with their primary care provider. So that area was going up, but we saw a substantial decrease in other areas. So fewer needs to go see specialists and slightly lower costs in terms of inpatient and emergency room costs.

药剂师在初级保健中的重要性

面试官: So what happens if a 药剂师 is not involved in decision-making at the primary care clinic? What's an example of what can go wrong or how they can make things go better?

Dr. McAdam-Marx: 作为治疗病人的 初级保健医生 变得越来越复杂, 更多慢性疾病, 多种慢性疾病, 他们需要服用多种药物, 通常. Sometimes these medications can interact or counteract each other and having a 药剂师 on the team who that's what they're trained to do, 优化药物治疗, 能在团队医疗中发挥巨大作用吗.

They provide input and guidance to the primary care providers on what are the most optimal drug therapies for a given patient and so, when a patient has the opportunity to meet with a 药剂师 and have a 药剂师 review their drug therapy, 经常有机会改变剂量, add medications or remove medications with the goal of helping that patient achieve the treatment goals that they're after: better disease control, fewer side effects in a more efficient and a more effective manner than might happen otherwise.

面试官: So do you find that patients are open to this idea of working with a 药剂师 as a primary healthcare provider? I mean, 大发娱乐习惯了好好思考, 至少我是这样, 也许这是我的偏见, I'm used to thinking of going to Walgreens and talking to the person behind the glass window and getting my medications that way. 这对人们来说是一种观念上的转变. 他们准备好了吗?

Dr. McAdam-Marx: 这是我的印象. To clarify, I'm a 研究er so I'm actually not the one delivering this care. But I have a team of very excellent clinical 药剂师s and their response is yes, definitely. They appreciate that their primary care provider is busy and they have a limited amount of time. 通常, they will meet with the 药剂师 before the physician comes into the room and they can have an extended conversation about their medications, 他们正在经历什么, 事情是如何运作的. 我认为他们认为药剂师是药物专家.

And keep in mind that many of these patients are older and they grew up in the day of independent pharmacy, 他们称药剂师为“医生”,“他们与他们有着非常私人的关系. So for them to transition that personal relationship out of the pharmacy and into the clinic, 这可能不像大发娱乐所想的那样是一种转变.

面试官: Great. 你还有什么要补充的吗?

Dr. McAdam-Marx: I'm excited to see the evolution of clinical pharmacy in the primary care setting and the growth in the profession itself. 药剂师 are trained specifically on drug knowledge and having that opportunity to carry that knowledge into the primary care setting, where, 坦白说, a lot of our care is delivered is really going to be very beneficial for patients, 大发娱乐提供者, 对纳税人, 医疗保健系统. So I think it is going to be a win-win-win for everyone that's involved.

面试官: 有趣，内容丰富，而且都是为了更好的健康. 大发娱乐是Scope健康科学广播.