Assuntos
Tratamento Farmacológico , Serviços de Assistência Domiciliar , Serviço de Farmácia Hospitalar , Região dos Apalaches , Interações Medicamentosas , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Estudos de Avaliação como Assunto , Humanos , Medicamentos sem Prescrição/efeitos adversos , Educação de Pacientes como Assunto , Farmacêuticos , Qualidade da Assistência à SaúdeRESUMO
A prototype computerized pharmaceutical services support system (CPSSS) is described. CPSSS maintains records on approximately 40,000 patients; 1,300 outpatient prescriptions are dispensed per day. Using Univac hardware and software developed inhouse, CPSSS provides an online drug therapy profile. The prescription label, including auxiliary information, storage and stability guidelines as well as the traditional information, is automatically generated. Prior to medication dispensing, all information is verified by a pharmacist after the computer searches the patient medication profile for 5,400 potential drug-drug, 1,500 drug-disease state, over 100 drug-allergy and 200 drug-laboratory test interactions as well as identifying duplicate pharmacological therapy. Retrospectively, the patient population is described as to sex, age and number of diagnoses. The number of prescriptions per physician also is reported. Twenty drugs represent one-half of the total prescriptions, with 32% of patients taking diuretics and 30% taking tranquilizers. All new prescriptions were prospectively reviewed. Approximately 2% had potential interactions or pharmacological duplication of therapy problems. Approximately 30% of all new prescriptions duplicated exactly an active prescription on file. When a pharmacist initiated physician contact as a result of CPSSS and profile review, physicians changed therapy approximately 73% of the time when informed of duplicate therapy, 27% of the time when informed of potential drug-disease state interactions and 32% of the time when informed of potential drug-drug interactions.
Assuntos
Assistência Ambulatorial , Computadores , Serviço de Farmácia Hospitalar , Serviços de Informação sobre Medicamentos , Interações Medicamentosas , Rotulagem de Medicamentos , Prescrições de Medicamentos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
A program involving a pharmacist in the management of ambulatory hypertensive patients is discussed. A hypertension monitoring protocol was developed by a physician and a pharmacist. The protocol provided for initial patient assessment and treatment by the physician, counseling and education of the patient by the pharmacist, patient follow-up by the pharmacist every one to two months and follow-up by the physician every four to six months. In the first four months of the program, 28 of 75 newly diagnosed hypertensive patients were referred by the physician to the pharmacist for follow-up.
