临床药师为老年糖尿病合并多种并发症患者合理安排用药时间的药学监护

Pharmaceutical Care of Medication Schedule for Elderly Diabetes Patients with Merge Complications by Clinical Pharmacists

目的:探索临床药师为老年糖尿病合并多种并发症患者提供药学服务的途径。方法:介绍临床药师根据时辰药理学、药物与食物、药物与药物间的相互作用等原理,为1例老年糖尿病合并多种并发症患者的服药时间进行合理调整并进行用药指导的过程。结果:患者按照临床药师制订的"服药时间指示图"调整服药时间,提高了药物的治疗效果,同时也提高了患者的用药依从性。经调整后患者血糖、血压控制理想,血肌酐、尿酸水平明显下降,病情稳定出院。结论:临床药师与患者良好的沟通,认真的用药指导,提高患者用药的依从性,对促进合理用药、最大程度发挥药物疗效具有重要作用。

OBJECTIVE： To explore the approach of pharmaceutical care for elderly diabetes patients with merge complications by clinical pharmacists. METHODS： Through the principles of chronopharmacology,drug and food and interactions between drugs,to introduce the rational adjustment of medication schedule in patients and the process of medication guidance for one elderly diabetes patient with merge complications by the clinical pharmacists. RESULTS：The patients adjusted the medication schedule via the＂indicator diagram of medication time＂formulated by the clinical pharmacists,the treatment efficacy of drugs and medication compliance were significantly improved. After adjustment,the blood glucose and pressure levels were perfectly controlled,levels of Scr and UA deceased obviously,the patient had discharged from the hospital with normal conditions. CONCLUSIONS： The communication between patients and clinical pharmacists,serious medication guidance and the improvement of medication compliance in patients all play important roles in the promotion of rational drug use and contribution of fully developing the drugs curative effect.