【摘要】 目的 验证临床药师对外科预防使用抗菌药物进行干预的效果。 方法 以临床药师督查记录数据为基础，将2010年1-3月238份病历设为非干预组，2010年10—12月240份病历设为干预组，建立评价标准，进行回顾性汇总、分析。 结果 通过干预，抗菌药物使用率从干预前的100%下降为77.08%（χ2=63.633，P=0.000），抗菌药物联用情况减少（χ2=53.712，P=0.000），用药时机和用药疗程有了较大改善，抗菌药物费用下降（t=-5.235，P=0.000），住院医疗费用降低（t’=-12.280，P=0.000），住院天数减少（t=-5.071，P=0.000）。 结论 临床药师通过实施合理用药干预对促进医院安全、有效、经济使用抗菌药物起到了积极作用。【Abstract】 Objective To verify the effect of clinical pharmacists’ intervention in antibiotics used for Type I incision surgical prevention. Methods Based on the supervision and inspection recording data of clinical pharmacists, we arranged 238 medical records in the first quarter of 2010 as non-intervened group and 240 medical records in the fourth quarter of 2010 as intervened group, and then established evaluation criteria and conducted a retrospective study for analysis. Results Through intervention, the rate of using antibiotics decreased from the previous 100% to 77.08% (χ2=63.633, P=0.000), the use of combined antibiotics also decreased (χ2=53.712, P=0.000), the time of course of using antibiotics improved, medical expenses of the antibiotics were reduced (t=-5.235, P=0.000), hospitalization cost decreased (t=-12.280, P=0.000), and hospital stay was shortened (t=-5.071, P=0.000). Conclusion Clinical pharmacists’ intervention in rational use of drugs play a positive role in contribution to a safe, effective and economical application of antibiotics.
【摘要】 目的 验证临床药师对我院中药注射剂合理使用进行干预的效果。 方法 对比分析2010年临床药师干预前后中药注射剂的合理使用情况，随机抽取2010年1-6月合格病历1 000份，设为非干预组；随机抽取2010年9月-2011年2月合格病历1 000份，设为干预组；评估临床药师的干预作用。 结果 非干预组中药注射剂的使用率为31.10%，干预组为19.00%，差异有统计学意义（χ2=38.991，P=0.000）；非干预组适应证不合理的为6.00%，干预组为2.10%，差异有统计学意义（χ2=19.570，P=0.000）；非干预组发生不良反应15例，干预组发生3例，两组不良反应发生率差异有统计学意义（χ2=8.073，P=0.004）；中药注射剂的用法用量趋于规范。 结论 临床药师对中药注射剂临床使用的干预行之有效，对促进医院安全、有效、合理使用中药注射剂起到了积极作用。【Abstract】 Objective To explore the effects of clinical pharmacists intervention on traditional chinese medicine injection. Methods Compared the rational usage of traditional Chinese medicine injection in 2010 after the intervention of clinical pharmacists. A total of 1 000 clinical case records from January to June 2010 were randomly selected and was named as the non-intervention group; another 1 000 clinical case records from September 2010 to February 2011 were randomly selected and was named as the intervention group. The effect of the clinical pharmacists were evaluated. Results The utilization rate of the Chinese medicine injection was 31.10% in non-intervention group and 19.00% in the intervention group with a significant difference between the two groups (χ2=38.991，P=0.000). The irrationality of indication was 6.00% in non-intervention group and 2.10 in the intervention group with a significant difference between the two groups （χ2=19.570，P=0.000）. The adverse reaction was found in 15 patients in non-intervention group and in three patients in the intervention group with a significant difference between the two groups（χ2=8.073，P=0.004）. The usage and dosage of Chinese traditional medicine injection was tend to be normative. Conclusion The intervention on traditional Chinese medicine injection by clinical pharmacists is effective, which is a important part in promoting the rational use of traditional Chinese medicine injection.
Objective To explore the way of clinical pharmacists participating in formulating the chemotherapy regimen for cancer and pharmaceutical monitoring, through the practice of drug treatment in a patient with gestational trophoblastic neoplasia. Methods Clinical pharmacists participated in the treatment of one patient with low-risk gestational trophoblastic neoplasia in gynecological chemotherapy ward, from the first chemotherapy in January 2015 to the clinical cure. The countermeasures included designating chemotherapy regimen, monitoring clinical efficacy and adverse reactions, changing the chemotherapy regimen in time when the curative effect was poor, and coping with adverse reactions. Results Physicians adopted the suggestions from clinical pharmacists and the patient was clinically cured after standardized treatment. Conclusion Pharmaceutical care by clinical pharmacists can assist clinicians to ensure the safety and effectiveness of drug use.
目的 探讨临床药师在支气管哮喘住院患者的药学监护作用。 方法 临床药师在呼吸科参与具体药物治疗的1例支气管哮喘住院患者药学监护过程进行分析总结。 结果 临床药师通过全程的药学监护，及时发现并解决相关药物治疗问题，为临床提供合理建议，加强了患者用药的安全性。 结论 临床药师实施药学监护对患者个体化治疗具有极其重要的意义。
Objective To evaluate the effect of physician-nurse-pharmacist collaboration on cardiovascular disease risk factors in diabetes patients. Methods Randomized controlled trails (RCTs) on collaboration among physicians, nurses and pharmacists for reducing cardiovascular disease risk factors in diabetes patients were collected from Cochrane Central Register of Controlled Trials, Medline (Ovid SP), Embase, China Knowledge Resource Integrated Database, VIP and WanFang. We screened the retrieved studies according to the inclusion and exclusion criteria, evaluated the quality of included studies, and then performed meta-analysis with the Cochrane Collaboration’s Revman 5.3.0 software. Results Seven RCTs were included. The results of meta-analysis showed that the change in glycosylated hemoglobin A1c, systolic blood pressure, diastolic blood pressure and low density lipoprotein-cholesterol were significantly reduced in the collaboration group than in usual care group [SMD=–0.39, 95%CI (–0.56, –0.21),P<0.000 1;SMD=–0.30, 95%CI (–0.43, –0.18),P<0.000 01;SMD=–0.37, 95%CI (–0.64, –0.11),P=0.006;SMD=–0.11, 95%CI (–0.16, –0.06),P<0.000 1]. Conclusions Collaboration among physicians, nurses and pharmacists is effective for reducing cardiovascular disease risk factors in diabetes patients. But its long-term efficacy still needs to be confirmed by performing higher quality, large sample RCTs with long-term follow-up.
ObjectiveTo investigate the management methods of drug repercussion and its intervention measures in the Burn and Plastic Surgery Department by analyzing the reasons for drug repercussion. MethodBased on the drug repercussion data provided by the computer information center, we analyzed the common reasons and the status quo of drug repercussion. Active intervention measures were carried out, and real-time supervision and feedback of drug repercussion management were also performed. We compared such repercussion indexes before intervention (between May and September 2013) and after intervention (between October 2013 and February 2014):number of drug repercussion patients, times of drug repercussion, amount of money involved in drug repercussion, ratio of drug repercussion and dispensing and comprehensive ranking of the drug repercussion in the whole hospital. ResultsAfter intervention, the ranking of the causes of drug repercussion changed obviously. Changing orders casually dropped to the 3rd of the rank, and changing the department based on necessity rose from the 4th to the 2nd. All the indexes (including the times, number, and amount of money of drug of repercussion, and the ratio of repercussion and dispensing and compreheasive rank) reduced significantly (P<0.05). ConclusionsActualizing active intervention measures redounds to reducing drug repercussion, standardizing clinical use of drugs, insuring safety, and advancing the satisfaction of patients and quality of medical nursing.
【摘要】 目的 探讨慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）治疗方案及药学监护的内容。 方法 以2007年12月收治的1例COPD患者为例，结合COPD治疗指南，为COPD急性加重期患者制定个体化的药学监护计划并实施全程的药学监护。 结果 患者COPD急性加重期的药物治疗方案有效合理。通过全程的药学监护，及时发现和解决了患者药物治疗的问题，为临床合理用药提供了意见。 结论 对COPD患者实施药学监护具有可行性和实用性。【Abstract】 Objective To investigate the treatment and pharmaceutical care for chronic obstructive pulmonary disease (COPD) patients. Methods In December 2007, a patient with COPD was diagnosed, and based on the clinical data, COPD treatment guidelines were adopted to analyze treatment plans. For patients with acute exacerbation of COPD, individualized pharmaceutical care plan was proposed, and pharmaceutical care was performed during the whole course of disease. Results The drug treatment for the one patient with acute exacerbation of COPD was effective and reasonable. Treatment problems were observed and solved through pharmaceutical care which had given reasonable suggestions for medication. Conclusion The implementation of pharmaceutical care for COPD patients is feasible and practical.