Enhanced care improves outcomes but usual care unlikely to do so

摘要

Evidence for improved patient outcomes with enhanced pharmacist care is strong, according to Ross Tsuyuki, associate professor of clinical epidemiology at the University of Alberta, Canada. Dr Tsuyuki's work has shown that pharmacist intervention in dyslip-idaemia improved cholesterol management in 57 per cent of the intervention group compared with 31 per cent of the usual care group, and low density lipoprotein (LDL) cholesterol was significantly lowered. Also, patients in a pharmacist run anticoagulant clinic were shown to have a three times lower risk of hospital admission and, in a further study, pharmacist intervention increased prescribing of an angiotensin-converting enzyme inhibitor in heart failure, from 58 per cent of patients on hospital admission to 83 per cent on discharge. However, evidence of benefit with "usual pharmacist care" does not exist and it is likely that it has no impact, he said. "Pharmacists need to be proactive in applying the evidence.