Evaluation of a pharmacist-managed electrolyte protocol in outpatients on antiarrhythmic medications
| Autor: | Melissa J. Snider, Jonathan Vecchiet, Mahmoud Houmsse, Cynthia A. Carnes, Andrea Hirsch, Victor P. Long |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Pharmacist Pharmacology (nursing) Pharmacy 030204 cardiovascular system & hematology Pharmacists 03 medical and health sciences Electrolytes 0302 clinical medicine Pharmacotherapy Outpatients medicine Humans 030212 general & internal medicine Adverse effect Ohio Retrospective Studies Pharmacology Protocol (science) business.industry Retrospective cohort study Middle Aged Pharmaceutical Services Emergency medicine Physical therapy Female Drug Monitoring business Serum potassium level Anti-Arrhythmia Agents Potassium supplementation Patient education |
| Zdroj: | Journal of the American Pharmacists Association : JAPhA. 57(4) |
| ISSN: | 1544-3450 |
| Popis: | Objective To evaluate the effectiveness of a pharmacist-managed treatment protocol in achieving and maintaining serum potassium level ([K + ]) in the desired range. Setting Antiarrhythmic Medications Clinic, The Ohio State University Wexner Medical Center, Columbus, Ohio, from 2009 to 2013. Practice description Patients are referred for antiarrhythmic monitoring at this pharmacist-run, electrophysiologist-supervised clinic. Each visit includes medication reconciliation for drug interaction identification, patient interview for potential adverse effects or arrhythmia symptoms, patient education, and drug therapy monitoring through ordering and review of objective testing. Practice innovation In 2009, a novel, pharmacist-managed electrolyte protocol was established for less than ideal [K + ] found during antiarrhythmic monitoring. The protocol was intended to standardize and improve practice, versus pre-protocol management through separate electrophysiology offices. The protocol was designed to maintain [K + ] of 4.0-5.0 mmol/L, and it used dietary advice and magnesium and potassium supplementation to normalize [K + ]. Evaluation The performance of the pharmacist-managed electrolyte protocol was evaluated in consecutive patients seen between June 2009 and July 2013 with [K + ] less than 4.0 mmol/L. [K + ] during initial visit and laboratory tests were scheduled at weekly intervals after intervention until corrected. Maintenance of [K + ] was assessed during the next visit to the clinic. Patients whose management involved pre-protocol between October 2008 and May 2009 at the clinic served as controls. Results One-hundred ninety-one encounters were evaluated from the post-protocol (treatment) group and 41 encounters from the pre-protocol (control) group. Desired [K + ] was reached in 161 (84%) post-protocol patient encounters, compared with 21 (49%) in the control group ( P P + ]. Conclusion A pharmacist-managed electrolyte protocol, implemented as part of a comprehensive antiarrhythmic monitoring service, effectively achieves and maintains desired [K + ]. |
| Databáze: | OpenAIRE |
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