Comparison of Amiodarone Compliance Monitoring： Usual Care, Electronic Prescribing Template and Pharmacist-Managed Clinic

作     者：Jeannie L. Poon Allison C. Brenner Michael J. Brenner 

作者机构：Veterans Affairs Ann Arbor Healthcare System Ann Arbor 48105 MI USA 

出 版 物：《Journal of Pharmacy and Pharmacology》 (药剂与药理学（英文版）)

年 卷 期：2014年第2卷第10期

页      面：621-626页

学科分类：1007[医学-药学(可授医学、理学学位)] 10[医学] 

主　　题：Amiodarone pharmacist-managed monitoring Veterans Affairs usual care electronic template. 

摘      要：Objective： To assess whether adherence to amiodarone monitoring differed pre- and post-amiodarone restriction template and implementation of the pharmacist-managed clinic. Design： This was a retrospective chart review study. Setting： A large, academically-affiliated Veteran Affairs Healthcare System providing primary and tertiary care. Patients： 580 patients were identified as having an active prescription for amiodarone for at least 60 days from January l, 2009 to August 31, 2013 and receiving primary care at the VAAHS （Veterans Affairs Ann Arbor Healthcare System）. Results： Nearly all patients had TSH and LFTs at baseline regardless of study group. Significant associations between baseline rates for CXR, ECG, PFT, and opbthalmologic exams were found, with higher rates in the clinic and template arms compared to usual care. Similar patterns for all monitoring outcome rates were also found for both the 6- and 12-month measures. Conclusions： Patients on amiodarone who are followed by a pharmacist-managed clinic or where a restricted ordering template was used had increased compliance with amiodarone monitoring guidelines compared to usual care. Use of a restricted template may be a reasonable option in place of a pharmacist-managed service.