肾内科临床药师有效用药干预的影响因素分析

Analysis of influence factors of effective drug intervention in nephrology department by clinical pharmacists

目的探讨临床药师开展用药干预的影响因素。方法利用医院信息平台和《医嘱审核记录》,临床药师提取2015-2017年进行用药干预的272例肾内科住院患者的医嘱干预内容,包括患者年龄、性别、用药品种数、药师提供的循证证据级别、接受干预的医师职称等,利用多元Logistic回归分析其与有效用药干预间的相关性。结果 272例用药干预中,有效干预168例,有效干预率为61. 76%。对有效用药干预影响因素分析显示,A级证据(P=0. 027)、主治及以下医师干预成功率高(P=0. 007),差异均有统计学意义。多元回归显示,A级证据与有效干预呈正相关(OR=1. 882),干预经验不足(干预年份2015)、医师职称级别高(副主任医师)与有效干预呈负相关(OR=0. 434、0. 393),差异均有统计学意义。结论加强重点用药监护,提高自身业务素养,有针对性的高质量循证证据、有效的医药沟通是临床药师用药干预的必要手段。

Objective To explore the influence factors of clinical pharmacists in medical intervention. Methods According to HIS system and medical reviewrecord in nephrology department,the clinical data of patients with medical interventions in our hospital from January 2015 to December 2017 were analyzed,including age,gender,drug types,level of evidence provided by the phamacists,and the title of doctors. ANOVA and multivariate Logistic analysis were used to analyze their correlation with the intervention results. Results In 272 cases of drug intervention,168 cases were of effective intervention,which accounted for 61. 76%. The analysis of influencing factors of effective drug use intervention showed that the intervention success rate of the A-level evidence（ P = 0. 027） and doctor-in-charge and belowwas high（ P = 0. 007）,and the difference was statistically significant. M ulti-factor Logistic regression analysis showed that A-level evidence was positively correlated with effective intervention（ OR = 1. 882）,while insufficient intervention experience（ intervention year 2015） and high professional title（ associate chief physician） were negatively related to effective intervention（ OR = 0. 434,0. 393）,the differences being statistically significant. Conclusion It is necessary for clinical pharmacists to strengthen drug monitoring,improve their professional accomplishment,provide high quality evidence and communicate with each other effectively.