临床药师参与1例老年患者的精准用药实践

Clinical Pharmacist's Participation in the Practice of Precise Drug Use in an Elderly Patient

目的建立多学科合作诊疗中临床药师个体化精准用药干预模式,探索临床药师参与合理用药管理新方法。方法临床药师参与1例老年患者围术期多重用药评估,分析临床合理用药精准干预的效果。结果该患者围术期的用药得到了合理调整,提高了用药安全性。结论合作诊疗模式可优化老年患者临床治疗方案,临床药师参与合作诊疗,可发挥个体化精准用药干预作用,提高用药安全性,为临床药学优质服务探索了新路径。

Objective To establish an individualized and precise drug use intervention model for clinical pharmacists in multidisciplinary cooperative diagnosis and treatment,and to explore a new model for clinical pharmacists to participate in rational drug use management.Methods The clinical pharmacists participated in the evaluation of multiple drug use during the perioperative period in an elderly patient and analyzed the effect of the precise intervention of rational drug use in the clinic.Results The patient's perioperative medication was rationally adjusted and the safety of drug use was improved.Conclusion Cooperative diagnosis and treatment model can optimize the clinical treatment of elderly patients.Clinical pharmacists can play an individualized and precise role in drug intervention,improve the safety of drug use and explore a new path for high-quality service of clinical pharmacy by participating in cooperative diagnosis and treatment.