药师在老年科临床药学实践的系统评价

发布时间：2018-03-11 00:16

本文选题：老年科　切入点：药师　出处：《中国医院药学杂志》2015年16期 　论文类型：期刊论文

【摘要】：目的:探索与评价药师基于老年科病房的临床药学实践的特征、内容及效果。方法:计算机检索PubMed、EMbase、Cochrane图书馆临床对照试验资料库、CHINAL、Clinical Trials、中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据库,检索时间均从建库至2014年10月31日。由2位评价员根据纳入与排除标准独立进行文献筛选、资料提取和质量评价并交叉核对后,进行系统评价,必要时采用STATA12.0进行Meta分析。结果:共纳入15篇文献,其中2篇为随机对照研究,7篇为队列研究,6篇为病例系列研究,共涉及2 796名患者。研究结果表明,药师在老年科进行临床实践实施地点、团队合作、实践时间、使用工具、实践目的均较为多样化,实践内容以医嘱审核(9/15)、药物重整(5/15)为主。在药师实践的效果方面,药师提出了药物重整、药物相关问题等多方面建议,药师建议被接受比例的范围为45.0%~90.0%;进行单臂的Meta分析后,整体而言,药师建议被接受的比例为63.7%[95%CI,(0.523,0.751)]。尽管药师的药学实践对死亡率、再入院率等终点指标效果并不明确,但能够提高患者的用药合理性,降低患者的用药复杂程度,提高患者的依从性,降低患者的额外就诊率[OR0.44,95%CI(0.22,0.88),P=0.021]。结论:药师在老年科的临床药学实践形式和内容多样化,临床实践可对临床产生积极的作用,仍需设计良好的研究进一步明确药师对于终点结局的效果。
[Abstract]:Objective: to explore and evaluate the characteristics of pharmacists' clinical pharmaceutical practice based on geriatric wards. Contents and effects. Methods: a computer-based search was conducted for the clinical controlled trials database of PubMedus EMbase Cochrane Library, Clinical Trials, CNKIUS, Chinese Biomedical Literature Database (CBMN), and Wanfang Database. The retrieval time was from the construction of the database to October 31st 2014. The two evaluators independently carried out the literature screening according to the inclusion and exclusion criteria, the data extraction, the quality evaluation and cross-check, and then carried out the systematic evaluation. STATA12.0 was used for Meta analysis when necessary. Results: a total of 15 articles were included, of which 2 were randomized controlled trials, 7 were cohort studies and 6 were case series studies involving 2 796 patients. Pharmacists carry out clinical practice in geriatrics, work as a team, practice time, use tools, and practice purposes are more diversified. The content of practice is mainly the examination of doctors' orders, 9 / 15 / 15, and 5 / 15 of drug reengineering.) in terms of the effect of pharmacists' practice, Pharmacists put forward many suggestions, such as drug reorganization, drug-related problems and so on. The range of acceptance ratio of pharmacists' recommendations was 45.0% and 90.0%. After single-arm Meta analysis, as a whole, The rate of acceptance recommended by pharmacists is 63.7% [95CIJ 0.5230.751]. Although pharmacists' pharmacists' pharmacist practice is not clear about the effects of terminus indicators such as mortality, readmission rate, etc., it can improve the rationality of drug use, reduce the complexity of drug use, and improve the compliance of patients. To reduce the extra visit rate of the patients [OR0.4495 CIQ 0.220.88P0. 021] conclusion: the pharmacists in geriatrics have diversified forms and contents of clinical pharmaceutical practice, and clinical practice can have a positive effect on clinical practice. Well-designed studies are still needed to further clarify the pharmacist's effect on endpoint outcomes.
【作者单位】：北京大学第三医院药剂科;北京大学药学院药事管理与临床药学系;
【分类号】：R95

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