临床药师干预对高血压患者药物使用合理率的影响

Effects of Clinical Pharmacist Intervention on Reasonable Rate of Drug Use in Hypertensive Patients

目的：探索临床药师参与临床治疗团队,对药物使用合理率的影响。方法：将我院2011年1-12月高血压及高血压伴发1~3种疾病的782份病历作为对照组;2012年9月-2013年8月高血压及高血压伴发1~3种疾病的1 061份病历作为观察组。把2组病例均划分为8个疾病组,临床药师对观察组进行干预后,比较对照组与观察组病例的药物使用合理率数据。结果：高血压、高血压伴发冠心病、高血压伴发心力衰竭、高血压伴发糖尿病、高血压伴发冠心病及心力衰竭组差异有统计学意义（P〈0.01）;高血压伴发冠心病及糖尿病组差异有统计学意义（P〈0.05）;高血压伴发心力衰竭及糖尿病组,高血压伴发冠心病、心力衰竭及糖尿病组,因样本量太小,差异无统计学意义（P〉0.05）。8组疾病组病例数汇总后比较药物使用不合理率,观察组与对照组差异有统计学意义（P〈0.01）。结论：临床药师在药学查房期间,通过对护士和患者的宣教以及药物在临床不合理使用的干预,可显著提高药物使用合理性,保证患者用药的安全、有效,达到医患共赢的效果。

OBJECTIVE： To explore the effects of clinical pharmacists involved in the treatment team on reasonable rate of drug use. METHODS： 782 cases of hypertension and hypertension complicating with one to three kinds of diseases were collect- ed from our hospital during Jan. to Dec. in 2011 as control group,1 061 cases of hypertension and hypertension complicating with one to three kinds of diseases were collected during Sept. 2012 to Aug. 2013 as observation group. The patients of 2 groups were divided into 8 sub-groups; the rationality data of drug use was compared between control group and observation group after clinical pharmacists provided education and intervened in observation group. RESULTS： Hypertension, hypertension complicating with coronary heart disease, heart failure, diabetes, or coronary heart disease and heart failure had significant dif- ferences （P〈0.01） ; hypertension complicating with coronary heart disease and diabetes had significant differences（P〈0.05） ; hypertension complicating with heart failure and diabetes, or coronary heart disease, heart failure and diabetes had no statistical significance due to small scale sample （P〉0.05）. There was significant difference in reasonable rate of drug use between obser- vation group and control group after summarizing case number of 8 sub-groups （P〈0.01）. CONCLUSIONS： Clinical pharma- cists provide education for nurse and patients and intervene in irrational drug use during ward round so as to improve rationality of drug use in the clinic, guarantee the safety and effectiveness of drug and obtain the common benefit of the patient and the hospital.