Ariane R Guthrie, Mahendra A Patel, Catherine J Sweet
{"title":"退伍军人的药剂师辅助伐尼克兰戒烟治疗。","authors":"Ariane R Guthrie, Mahendra A Patel, Catherine J Sweet","doi":"10.12788/fp.0290","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Pharmacists are uniquely positioned to provide tobacco cessation interventions given their medication expertise and accessibility to the public. The purpose of this study was to evaluate the efficacy and safety of management of varenicline by clinical pharmacy specialists (CPSs) compared with other clinicians.</p><p><strong>Methods: </strong>This retrospective chart review included patients with a varenicline prescription between July 1, 2019, and July 31, 2020. Primary outcomes were reduction in tobacco use at 12 weeks from baseline, continuous abstinence at 12 weeks, adherence to varenicline therapy, and time to first follow-up. For safety evaluation, charts were reviewed for documented adverse drug reactions.</p><p><strong>Results: </strong>Management by CPS compared with other clinicians was associated with similar mean (SD) reductions of tobacco use (-7.9 [10.4] vs -5.4 [9.8] cigarettes per day, respectively; <i>P</i> = .15) and rates of complete abstinence (34% vs 38%, respectively; <i>P</i> = .73) and higher adherence (42% vs 31%, respectively; <i>P</i> = .01). Mean (SD) time to first follow-up was shorter for patients in the CPS group: 52 (66) vs 163 (110) days; <i>P</i> < .001. Adverse events were more common in the CPS group compared with the other clinicians group (42% vs 23%; <i>P</i> = .02).</p><p><strong>Conclusions: </strong>These results suggest that CPS management of varenicline is as safe and effective as management by other clinicians. Additional research is needed to fully characterize the impact of pharmacist management of varenicline, justify expansion of CPS scope of practice, and ultimately enhance patient outcomes regarding tobacco cessation.</p>","PeriodicalId":73021,"journal":{"name":"Federal practitioner : for the health care professionals of the VA, DoD, and PHS","volume":"39 7","pages":"304-309"},"PeriodicalIF":0.0000,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9648582/pdf/fp-39-07-304.pdf","citationCount":"0","resultStr":"{\"title\":\"Pharmacist-Assisted Varenicline Tobacco Cessation Treatment for Veterans.\",\"authors\":\"Ariane R Guthrie, Mahendra A Patel, Catherine J Sweet\",\"doi\":\"10.12788/fp.0290\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Pharmacists are uniquely positioned to provide tobacco cessation interventions given their medication expertise and accessibility to the public. The purpose of this study was to evaluate the efficacy and safety of management of varenicline by clinical pharmacy specialists (CPSs) compared with other clinicians.</p><p><strong>Methods: </strong>This retrospective chart review included patients with a varenicline prescription between July 1, 2019, and July 31, 2020. Primary outcomes were reduction in tobacco use at 12 weeks from baseline, continuous abstinence at 12 weeks, adherence to varenicline therapy, and time to first follow-up. For safety evaluation, charts were reviewed for documented adverse drug reactions.</p><p><strong>Results: </strong>Management by CPS compared with other clinicians was associated with similar mean (SD) reductions of tobacco use (-7.9 [10.4] vs -5.4 [9.8] cigarettes per day, respectively; <i>P</i> = .15) and rates of complete abstinence (34% vs 38%, respectively; <i>P</i> = .73) and higher adherence (42% vs 31%, respectively; <i>P</i> = .01). Mean (SD) time to first follow-up was shorter for patients in the CPS group: 52 (66) vs 163 (110) days; <i>P</i> < .001. Adverse events were more common in the CPS group compared with the other clinicians group (42% vs 23%; <i>P</i> = .02).</p><p><strong>Conclusions: </strong>These results suggest that CPS management of varenicline is as safe and effective as management by other clinicians. Additional research is needed to fully characterize the impact of pharmacist management of varenicline, justify expansion of CPS scope of practice, and ultimately enhance patient outcomes regarding tobacco cessation.</p>\",\"PeriodicalId\":73021,\"journal\":{\"name\":\"Federal practitioner : for the health care professionals of the VA, DoD, and PHS\",\"volume\":\"39 7\",\"pages\":\"304-309\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9648582/pdf/fp-39-07-304.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Federal practitioner : for the health care professionals of the VA, DoD, and PHS\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.12788/fp.0290\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/7/15 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Federal practitioner : for the health care professionals of the VA, DoD, and PHS","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.12788/fp.0290","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/7/15 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景:药剂师在提供戒烟干预方面具有独特的地位,因为他们的药物专业知识和公众的可及性。本研究的目的是评价临床药学专家(cps)与其他临床医生对伐尼克兰管理的有效性和安全性。方法:本回顾性研究纳入2019年7月1日至2020年7月31日期间服用伐尼克兰处方的患者。主要结局是在12周时从基线开始减少烟草使用,12周时持续戒烟,坚持伐尼克兰治疗,以及第一次随访的时间。为了安全性评估,我们回顾了药物不良反应的记录。结果:与其他临床医生相比,CPS管理与烟草使用减少的平均(SD)相似(分别为-7.9[10.4]和-5.4[9.8]支/天);P = 0.15)和完全戒断率(分别为34% vs 38%;P = 0.73)和更高的依从性(分别为42% vs 31%;P = 0.01)。CPS组患者到首次随访的平均(SD)时间更短:52(66)天和163(110)天;P < 0.001。与其他临床医生组相比,CPS组的不良事件更常见(42% vs 23%;P = .02)。结论:这些结果表明,瓦伦尼克兰的CPS管理与其他临床医生的管理一样安全有效。需要进一步的研究来充分描述varenicline药师管理的影响,证明CPS实践范围的扩大,并最终提高患者戒烟的结果。
Pharmacist-Assisted Varenicline Tobacco Cessation Treatment for Veterans.
Background: Pharmacists are uniquely positioned to provide tobacco cessation interventions given their medication expertise and accessibility to the public. The purpose of this study was to evaluate the efficacy and safety of management of varenicline by clinical pharmacy specialists (CPSs) compared with other clinicians.
Methods: This retrospective chart review included patients with a varenicline prescription between July 1, 2019, and July 31, 2020. Primary outcomes were reduction in tobacco use at 12 weeks from baseline, continuous abstinence at 12 weeks, adherence to varenicline therapy, and time to first follow-up. For safety evaluation, charts were reviewed for documented adverse drug reactions.
Results: Management by CPS compared with other clinicians was associated with similar mean (SD) reductions of tobacco use (-7.9 [10.4] vs -5.4 [9.8] cigarettes per day, respectively; P = .15) and rates of complete abstinence (34% vs 38%, respectively; P = .73) and higher adherence (42% vs 31%, respectively; P = .01). Mean (SD) time to first follow-up was shorter for patients in the CPS group: 52 (66) vs 163 (110) days; P < .001. Adverse events were more common in the CPS group compared with the other clinicians group (42% vs 23%; P = .02).
Conclusions: These results suggest that CPS management of varenicline is as safe and effective as management by other clinicians. Additional research is needed to fully characterize the impact of pharmacist management of varenicline, justify expansion of CPS scope of practice, and ultimately enhance patient outcomes regarding tobacco cessation.