临床药师参与口服靶向药物不良反应的管理模式及效果评价

Management of Adverse Reactions of Oral Targeted Drugs by Clinical Pharmacists and Its Effect Evaluation

目的通过构建不良反应管理团队,临床药师直接参与口服靶向药物不良反应的管理,优化管理患者长期口服靶向药物安全性。方法建立不良反应事件管理团队,临床药师对患者实施全程监护。收集我院54例口服吉非替尼的出院肺癌患者,对其在院期间实施用药教育,出院后定期电话随访,同时加强用药教育,指导不良反应的处理措施。调查药学监护后患者对靶向药物的认知度情况。结果通过构建医、药、护医疗团队对口服靶向药物患者集中管理,临床药师直接参与患者长期口服靶向药物药学监护,定期随访为患者提供药学服务,可降低靶向药物的不良反应严重程度,提高患者对靶向药物的认识度及不良反应的接受度。结论建立药师定期随访加强用药教育可预先管理长期口服靶向药物的不良反应,同时实现患者的自我管理,优化患者长期口服靶向药物的治疗结果,提高患者用药依从性和生活质量。

OBJECTIVE To explore the role of clinical pharmacists in safety management of long-term administration of oral tar- geted drugs by establishing a team for management of adverse reactions and providing pharmaceutical care. METHODS Inpatients receiving oral gefitinib （250 mg QD） were enrolled in the study between January 2014 and December 2014. Clinical pharmacists pro- vided education and instruction to patients on how to deal with adverse effects during gefitinib treatment. After the discharge, the clini- cal pharmacists supplied regular follow-up for patients. Finally, a survey of patients＇ awareness of targeted drugs was conducted after the pharmaceutical care. RESULTS The pharmaceutical care could attenuate the severity of adverse reactions. It also improved pa- tient acceptance and understanding of targeted drugs and reduced the adverse reactions. CONCLUSION Provision of regular follow- up and strengthened patient education by pharmacists can pre-manage the adverse drug reactions of long-term oral targeted drugs treat- ment, achieve patient self-management and improve their medication compliance and quality of life.