心内科与血管外科临床医师使用抗凝药情况的调查分析

Investigation and analysis of the usage of anticoagulants in cardiology and vascular surgery clinicians

目的:了解心内科与血管外科临床医师对抗凝药物的使用情况以及对临床药师的需求,为临床药师开展抗凝药物治疗管理探索方向。方法:经预调研修正后,对心内科、血管外科临床医师发放自行设计的问卷进行问卷调查,并对调查结果进行统计分析。结果:共回收有效问卷111份,回收率88.9%。仅54.9%的医师表示对肝素和华法林的个体化使用有经验,11. 7%的医师承认对两药的剂量调整均无经验;对于新型口服抗凝药和华法林,更多的医师(41.4%)倾向于选择使用前者;仅有7.2%的医师在遇到抗凝用药问题时选择咨询临床药师。医师对临床药师的服务需求排前3位的分别是合理用药建议(93.7%)、药物信息咨询(86.5%)和药品使用相关培训(80.2%)。结论:部分临床医师尤其是年轻医师,对抗凝药物的掌握情况有待提高,而临床药师在抗凝治疗管理方面对医师的影响有限。临床药师可在肝素和华法林的个体化使用、新型口服抗凝药的合理用药培训等方面为医师提供有针对性的服务,以不断满足医师对临床药师的需求。

Objective To investigation and analyse the usage of anticoagulants in cardiology and vascular surgery clinicians and their needs for clinical pharmacists,in order to explore the direction for clinical pharmacists in the management of anticoagulant drugs.Methods After pre-investigation and revision,self-designed questionnaires were sent to clinical doctors of Cardiology and Vascular Surgery Deparment,and the results were analyzed statistically.Results A total of 111 valid questionnaires were collected,with a response rate of 88.9%.Only 54.9% of the respondents had experience in the individualized usage of heparin and warfarin,and 11.7% did not have any experience in the usage of these two medicines.Most clinicians（41.4%） preferred to novel oral anticoagulants（NOACs） rather than warfarin,and only 7.2% preferred to consult clinical practice when they encountered anticoagulant problems.The top three service requirements for clinical pharmacists were rational drug use advice（93.7%）,drug information consultation（86.5%） and drug use related training（80.2%）.Conclusion Some clinicians,especially young physicians,need to improve their mastery of anticoagulant drugs,while clinical pharmacists have limited influence on the management of anticoagulant therapy.Clinical pharmacists can provide targeted services to physicians in the individualized usage of heparin and warfarin,and in the training of rational usage of new oral anticoagulants,so as to continuously meet the needs of physicians for clinical pharmacists.