临床药师开展内科住院患者入院药物重整的药学服务实践

发布时间：2018-05-30 12:12

本文选题：临床药师 + 药物重整　；参考：《中国药房》2017年32期

【摘要】：目的:探讨临床药师在慢性疾病患者药物治疗中的重要性和必要性以及开展药物重整(MR)的可行性,为临床药学内科工作模式的建立提供依据。方法:以2016年5-7月于我院呼吸内科住院的患者为研究对象,介绍临床药师在患者入院当日进行详细的药学问诊后,分别对患者的长期用药进行MR的情况。结果:通过临床药师对住院患者用药过程中存在的问题进行分类归整,共获得98例住院患者的入院MR记录,涉及296条药物医嘱,其中存在用药差错96条。参与MR的患者中,依从性好者仅有44例(占44.9%),其他患者均存在部分用药差错,主要表现为用药随意、用法用量不当、担心药物副作用而拒绝用药、因不良反应而停药、特殊疾病未随访导致用药剂量过量或不足、与医师沟通不畅导致用药错误、忘记服药/漏服和过度医疗等。发生用药差错的药物种类以心血管系统药物最常见,其次为呼吸系统药物和内分泌系统药物。结论:临床药师开展入院MR,有利于识别和纠正患者用药差错,避免潜在的用药差错,且有助于疾病控制,可作为内科病区药学服务工作的项目之一。
[Abstract]:Objective: To explore the importance and necessity of clinical pharmacists in the treatment of chronic diseases, and to provide the basis for the establishment of MR in clinical pharmacy. Methods: the patients who were hospitalized in the respiratory department of our hospital in 5-7 months of 2016 were used as the research object, and the clinical pharmacists were introduced on the day of admission to hospital. After the detailed pharmaceutical inquiry, the patient's long-term use of MR was carried out respectively. Results: through the classification and integration of the problems in the hospitalized patients, 98 hospitalized patients' hospitalized MR records were obtained, involving 296 medical orders, including 96 errors in drug use. The compliance of the patients involved in MR was good. There were only 44 cases (44.9%), and other patients had partial medication errors. The main manifestations were random use of drugs, improper use and dosage, fear of adverse drug effects and refusing to use drugs. Medicine and other drugs are most common in cardiovascular system drugs, followed by respiratory system drugs and endocrine system drugs. Conclusion: clinical pharmacists to carry out MR in hospital is conducive to identifying and correcting patients' medication errors, avoiding potential medication errors, and helping to control the disease, which can be used as a pharmaceutical service in the Department of internal medicine. One of the projects.
【作者单位】：上海交通大学医学院附属新华医院药学部;
【基金】：上海交通大学医学院医院药学科研基金资助项目(No.JDYX2016QN005)
【分类号】：R952

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