Innovation : une clinique réseau d'anticoagulothérapie dans votre pharmacie
Bibliographic record
Abstract
Resume Objectif : La population vieillissante du Quebec augmente la necessite d’assurer des suivis dans un reseau aux prises avec une penurie de medecins. Cet article presente une clinique reseau d’anticoagulotherapie mise en place par les pharmaciens de la Beauce. Mise en contexte : La Clinique reseau d’anticoagulotherapie permet aux pharmaciens communautaires d’ajuster et de suivre les ratios normalises internationaux de ses patients. Ce service se revele un outil de valorisation du role du pharmacien comme intervenant de premiere ligne tout en presentant des avantages cliniques pour la population de Chaudiere- Appalaches, il contribue a engendrer des gains d’efficience considerables et favorise le developpement d’un reseau d’expertise. Resultats : Depuis la mise en place de la clinique reseau d’anticoagulotherapie, l’efficacite clinique de la warfarine est passee de 45 %, lorsque le suivi etait fait de facon traditionnelle par les medecins, a 70 % lorsque le suivi est effectue par les pharmaciens. Une diminution des couts lies a la sante a ete observee : une reduction de 20 000 $ par an pour le centre de sante et de services sociaux en services de laboratoire, une diminution de 10 a 20 heures par semaine en temps d’exercice d’une infirmiere en centres locaux de services communautaires (soit une economie de 15 000 a 20 000 $/an), une reduction moyenne de 2612,5 heures pour les medecins et une economie pour la Regie de l’assurance maladie du Quebec de 20 000 $ en frais d’honoraires aux pharmaciens. Discussion : Les economies ont ete evaluees a 1 250 000 $ pour l’ensemble de la region de la Beauce. Conclusion : La Clinique reseau d’anticoagulotherapie represente un projet novateur. Sa mise en place a demontre une amelioration de la performance clinique de la warfarine. Abstract Objective: In Quebec, both an aging population and a shortage of physicians emphasize the need for follow-up of patients. This article discusses the implementation of an anticoagulation clinic by pharmacists in the Beauce region of Quebec. Context: The anticoagulation clinic enables community pharmacists to follow and adjust the international normalized ratios of their patients. This service has shown itself to be useful in raising awareness about the role of the pharmacist as a front-line professional. As well as demonstrating the clinical benefits to the Chaudiere-Appalaches population, the clinic also helps to considerably increase efficiency and promotes the development of a network of expertise. Results: Since the implementation of the anticoagulation clinic, the clinical efficacy of warfarin has increased from 45%, when monitoring was traditionally done by physicians, to 70%, when monitoring was done by pharmacists. A decrease in health-related costs was also observed: a reduction of $20,000 per year in laboratory costs for the Health and Social Service Centres, a decrease of 10–20 hours a week in CLSC nursing time (resulting in cost savings of $15,000 to $20,000 per year), an average reduction of 2612.5 hours for physicians, and savings in billing fees by pharmacists of $20,000 for the Regie de l’assurance maladie du Quebec. Discussion: Cost savings were evaluated at $1,250,000 for the entire Beauce region. Conclusion: The anticoagulation clinic is an innovative project. Its implementation has resulted in a demonstrable improvement in the clinical performance of warfarin. Key words: anticoagulotherapy, monitoring, adjustement, pharmacist
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.017 | 0.028 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.002 | 0.003 |
| Scholarly communication | 0.005 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.012 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".