临床药师提高化疗用药安全的药学服务措施

Pharmaceutical Care Measures for Improving the Safety of Chemotherapy by Clinical Pharmacists

目的:探讨临床药师开展药学服务在提高化疗用药安全方面的措施与作用。方法:收集我院肿瘤科2013年1-12月(干预前)、2014年4月-2015年3月(干预后)化疗药物致药品不良反应(ADR)病例,对化疗方案、患者年龄与性别、给药途径、累及器官/系统、重度ADR等情况进行比较分析。结果:临床药师制订并实施促进化疗药物安全使用的药学服务措施干预后,化疗药物ADR发生率由88.48%降至72.14%,累及消化系统、皮肤及其附件的ADR发生率分别由67.28%、7.37%降至42.29%、1.99%,重度恶心呕吐的发生率由27.65%降至18.91%,单药化疗方案、口服给药途径相对安全,其构成比分别由31.80%(69/217)、14.29%(31/217)升至44.28%(89/201)、22.39%(45/201),差异均有统计学意义(P<0.05)。结论:临床药师制订的药学服务干预措施能显著降低化疗药物的ADR发生率,促进化疗药物的安全使用,保障患者的用药安全。

OBJECTIVE：To investigate the measures and roles of pharmaceutical care in improving the safety of chemotherapy by clinical pharmacists. METHODS：Chemotherapy drug-induced ADR medical records were collected from oncology department of our hospital during Jan.-Dec. 2013（before intervention）and Apr. 2014-Mar. 2015（after intervention）,and then analyzed and compared in respects of chemotherapy plan,patient＇age and gender,route of administration,involved organs and systems,severe ADR,etc. RESULTS：After the formulation and implementation of pharmaceutical care for improving safe use of chemotherapy drugs,the incidence of chemotherapy drugs-induced ADR decreased from 88.48% to 72.14%;the incidence of ADR of involved digestive system,skin and its appendants decreased from 67.28% and 7.37% to 42.29% and 1.99%,respectively;the incidence of severe nausea and vomiting decreased from 27.65% to 18.91%;the constituent ratio of single agent chemotherapy and oral administration route increased from 31.80%（69/217）and 14.29%（31/217）to 44.28%（89/201）and 22.39%（45/201）,respectively（P〈0.05）. CONCLUSIONS：Pharmaceutical care intervention measures formulated by clinical pharmacists can significantly lower the incidence of ADR,promote safe use of chemotherapy drugs and guarantee the safety of drug use.