临床药师干预骨科围术期不合理用药的效果评价

Effect of intervention by clinical pharmacists on unreasonable medication in orthopaedics department during perioperative period

目的评价医院临床药师干预骨科围术期不合理用药的效果。方法分别抽取医院2010年1月出院病历(干预前)及2010年7月出院病历(干预后),对围术期预防性应用抗菌药物的合理性进行比较。结果经临床药师干预,围术期患者预防性用药在适应证、药物选择、用法用量、超权限应用、溶媒选择、给药途径、联合用药、给药时机方面较干预前均明显改善;住院药品总费用占总住院费用的比例由30.4%降至28.0%,抗菌药物总费用占总药品费用的比例由32.9%降至22.1%;总住院时间和抗菌药物应用时间分别下降2.0d和1.5d。结论干预后医院合理用药水平有显著提高,减少了患者的住院时间和住院费用,临床药师参与临床合理用药,干预措施有效。

OBJECTIVE To assess the effect of intervention by clinical pharmacists on the unreasonable medication in orthopaedics department during perioperative period. METHODS The medical records of the patients who discharged in Jan 2010 （before the intervention） and Jul 2010 （after intervention） were selected respectively, the rationality of prophylactic use of antibiotics during during perioperative period was compared. RESULTS After the intervention by clinical pharmacists, the preventive application of antibiotics during perioperative period was distinctly improved in the indications, choice of medicine, application and dosage, application beyond the authority, choice of menstruum, medication route, combined medication as well as medication opportunity as compared with that before the intervention; the percentage of total hospitalization medicine expense on the total hospitalization expense decreased from 30. 4%to 28.0%, and the percentage of total antimicrobial agents expense on total medicine expense decreased from 32. 9% to 22. 1%; the total hospital stay and the duration of using antibiotics decreased by 2. 0 d and 1. 5 d respectively. CONCLUSION The reasonable medication has been significantly improved after the intervention, which results in the decrease of both hospital stay and hospitalization cost, the clinical pharmacists＇ participating in the intervention in reasonable use of antibiotics is effective.