临床药师参与临床路径各环节实施的合理用药探讨

Rational Drug Use in the Implementation of Clinical Pharmacists Participating in Clinical Pathway

目的探讨临床药师参与临床路径各环节实施对合理用药的促进作用。方法采用整群抽样法,分别于医院落实临床药师参与临床路径各环节措施前后,从医院门诊处方中抽取处方各500张,分为观察组(实施后)和对照组(实施前),对比处方药品种类及费用、抗生素使用情况、基本药物及中药处方使用情况。结果观察组处方药品种类明显少于对照组,处方费用明显高于对照组,差异有统计学意义(P<0.05);观察组抗生素处方使用率明显低于对照组,且抗生素单用使用率也明显低于对照组,差异有统计学意义(P<0.05);观察组基本药物处方用药率明显更高,中药处方使用率明显上升,差异有统计学意义(P<0.05)。结论临床药师参与临床路径各环节的实施,有助于促进合理用药,但难以降低处方费用。

Objective To explore the clinical pharmacists′ participation in the implementation of various clinical pathways, to promote rational drug use. Methods 500 pieces each of before and after the implementation of clinical pharmacists participating in the clinical pathway were selected using cluster sampling method and were taken as the control group and the observation group. The drug types, cost, the usage of antibiotics, essential drugs, and TCM in the prescriptions were compared. Results The types of prescription drugs in the observstion group was significantly less than the control group, and the prescription costs were significantly higher, the differences were statistically significant （ P 〈 0. 05 ）;the antibiotics usage in the observation group was significantly lower than the control group, and the usage of antibiotics alone was also significantly lower than the control group, the differences were statistically significant （ P 〈0. 05 ）;the usage of essential drugs was significantly higher in the observation group, and the usage of TCM showed significant increase, the differences were statistically significant （ P 〈 0. 05 ） . Conclusion The clinical pharmacists participating in the implementation of various aspects of clinical pathway can help promote rational drug use, but it is still difficult to reduce prescription costs.