临床药师在实施慢性阻塞性肺疾病临床路径中的作用分析

Analysis of the Role of Pharmacist in Implementation of Clinical Pathway of Chronic Obstructive Pulmonary Disease

目的:对临床药师参与慢性阻塞性肺疾病(COPD)临床路径的过程进行分析,讨论临床药师在实施临床路径中的工作模式及作用。方法:将纳入COPD临床路径的患者分为治疗组和对照组,临床药师通过戴明循环(PDCA)模式参与管理治疗组患者的药物治疗,经过2个PDCA循环后,对比分析2个循环组及治疗组和对照组病例平均住院日、平均住院费、药物治疗费、药品不良反应(ADR)发生率、患者药物治疗依从性、满意度有无统计学意义。结果:2个PDCA循环组之间药物治疗费差异有统计学意义(P<0.05);平均住院日、平均住院费、ADR发生率、药物治疗依从性、满意度差异无统计学意义(P>0.05);治疗组与对照组比较除平均住院日、平均住院费差异无统计学意义外,药物治疗费、ADR发生率、药物治疗依从性、满意度差异均有统计学意义(P<0.05)。结论:临床药师通过PDCA的管理模式参与临床路径的实施,能够有效促进药物治疗的规范使用、加强患者的药物治疗监护,ADR得到及时处置和上报,患者药物治疗依从性和满意度得到提高。

Objective：To evaluate and discuss the work mode and role of clinical pharmacist in participation in the implementation of clinical pathway of chronic obstructive pulmonary disease（COPD）.Methods：The patients with COPD in the clinical pathway were divided into treatment group and control group. The clinical pharmacists participated in the management of medication of the patients in treatment group through PDCA mode. After two cycles of PDCA,the comparative analysis of statistical significance was made among the two circulation groups and treatment and control groups in the aspects of the average length and expense of hospitalization,medication cost,ADR incidence,drug therapy adherence and the degree of satisfaction.Results：The difference of medication cost between the two PDCA cycle groups had statistical significance（P〈0.05）but the average length and expense of hospitalization,ADR incidence,the drug therapy adherence and the degree of satisfaction had no statistical significance（P＆gt;0.05）. Compared with the control group,other than the average length and cost of hospitalization which had no significance in treatment group,the medication cost,ADR incidence,drug therapy adherence and degree of satisfaction all had statistical significance（P〉0.05）.Conclusion：By means of PDCA management mode,the participation of clinical pharmacists in the implementation of clinical pathway can effectively promote the standardized medication,strengthen the medication care of patients,and make a timely disposal and report of ADRs. The patient medication compliance and the degree of satisfaction were improved.