全程管理模式对临床药师抗感染会诊效果影响的前后对照单臂观察性研究

The influence of whole-course management model on the anti-infection consultation effect of clinical pharmacists:a before-and-after controlled single-arm observational study

目的 探讨全程管理模式对医院临床药师抗感染会诊的影响效果。方法 对长沙市第四医院临床药师抗感染会诊实施全程管理模式前(2021年2—7月)的592例会诊病例和实施全程管理模式后(2022年2—7月)的688例会诊病例的抗菌药物使用疗程、抗菌药物使用品种数、抗菌药物使用费用、抗菌药物使用累计DDD(限定日剂量)数、抗菌药物使用强度、病人住院天数、病人住院费用和病人住院药品费用等指标进行对比和分析。结果 实施全程管理模式后,临床药师参与管理的抗感染会诊病例的抗菌药物使用累计DDD数减少3.31(实施前21.16±19.65,实施后17.85±16.09)、抗菌药物使用强度减少6.79(实施前103.22±58.37,实施后96.43±48.80)、病人住院天数减少2.26 d[实施前(20.59±13.13)d,实施后(18.33±11.71)d],抗菌药物使用天数、抗菌药物使用品种数、抗菌药物使用费用、病人住院费用以及病人住院药品费用等指标差异无统计学意义。结论 全程管理模式对临床药师抗感染会诊效果影响显著,对降低临床药师参与抗感染会诊病例的抗菌药物使用强度及减轻病人疾病负担具有重要意义,值得推广应用。

Objective To explore the effect of a whole-course management model on anti-infection consultations of clinical pharma-cists in a hospital.Methods The course of antibiotic use,the number of varieties of antimicrobial usage,the antimicrobial drug use cost,the cumulative DDD(limited days)number of antibiotic use,the intensity of antibiotic use,the length of hospital stay,the hospitali-sation cost and the hospitalisation drug cost of 592 cases before the implementation of the whole-course management model(February to July 2021)and 688 cases after the implementation of the whole-course management model(February to July 2022)in the anti-infection consultation of clinical pharmacists in the Fourth Hospital of Changsha were compared and analyzed.Results After the implementation of the whole-course management model,the cumulative DDD number of antibiotic use in the anti-infection consultation cases managed by clinical pharmacists was reduced by 3.31(21.16±19.65 before implementation,17.85±16.09 after implementation),the intensity of antibiotic use was reduced by 6.79(103.22±58.37 before implementation,96.43±48.80 after implementation),and the length of hospital stays was reduced by 2.26 days[(20.59±13.13)days before implementation,(18.33±11.71)days after implementation].There was no sig-nificant difference in the course of antibiotic use,the number of antibacterial drugs used,the cost of antibacterial drugs used,hospitalisa-tion costs or the cost of inpatient drugs.Conclusion The whole-course management model has a significant impact on the effect of clini-cal pharmacists'anti-infection consultations,which is of great significance to reduce the intensity of antibacterial drug use and reduce the disease burden of patients in clinical pharmacists'anti-infection consultations and is worthy of promotion and application.