药物整合在呼吸内科患者用药差错防范中的应用

Application of Medication Reconciliation in Preventing Medication Errors in Patients of Respiratory Medicine Department

目的:探讨开展药物整合服务在促进合理用药、防范呼吸内科患者用药差错及风险中的作用。方法:临床药师通过回顾性病历调查分析,收集患者既往用药史、整理入院药物治疗医嘱清单,对2014年12月-2015年9月收住呼吸内科的95例患者进行药物整合,并探查临床用药中不合理问题及存在的风险。结果:临床药师问诊针对用药品种、用法用量及不良反应方面更详细;通过药物整合,发现不合理用药及风险共109例次,重复用药占42.20%,药物遗漏占11.01%,药物使用无指征占8.26%,不良相互作用占8.26%;针对药师发现的问题,87.16%被医师采纳并调整给药。结论:药物整合对促进合理用药、防范用药差错及风险具有重要的作用,为临床药师开展药学服务提供了一种新的方式。

Objective： To discuss the effects of medication reconciliation in promoting the rational drug use and preventing medication errors and risks of inpatients of respiratory medicine department. Methods： The medication history and prescriptions of inpatients were collected and analyzed by clinical pharmacists using the method of retrospective medical records analysis. The medication reconciliation was performed in 95 patients hospitalized in respiratory medicine department from December 2014 to September 2015. The problems and risks of clinical irrational drug use were also explored. Results： Clinical pharmacists investigated the varieties of drugs, usage and dosage and adverse drug reactions in detail. A total of 109 cases of irrational drug use and risks of medication were found through the medication reconciliation, repeated medication accounting for 42.20%, drug omission accounting for 11.01%, drug use without indications accounting for 8.26%, adverse interaction accounting for 8.26%. 87.16% of the problems found by clinical pharmacists were recognized and adjusted by physicians. Conclusion： Medication reconciliation plays an important role in promoting rational drug use, preventing medication errors and risks, and providing a new way of pharmacy services for clinical pharmacists.