合作药物治疗管理模式下临床药师在围术期疼痛管理中的作用

Role of clinical pharmacists in perioperative pain management under collaborative drug therapy management model

目的通过开展2014-2016年围术期疼痛管理的实践,简述在合作药物治疗管理(CDTM)工作模式下临床药师在围术期疼痛管理过程各环节发挥的积极作用。方法构建以临床药师为主导的CDTM围术期疼痛管理团队工作模式,医院成立了以临床药师为主导的、由多学科合作的急性疼痛管理(APS)小组,对患者围术期疼痛进行全面管理,制定治疗协议、参与患者治疗。结果相比于2013年,APS管理小组成立后(2014-2016),患者术后的动、静态VAS疼痛评分降低;第1~3天的睡眠质量明显改善;不良反应总发生率降低(P<0.05);不良反应的发生种类减少且均未出现严重不良反应。结论应用CDTM工作模式下以临床药师为主导的APS小组可以更好地控制手术患者的疼痛,帮助患者更好地度过术后恢复期。在CDTM工作模式下,临床药师在围术期疼痛管理过程中发挥了非常积极的作用。

AIM Based on the practice of perioperative pain management in the Nanjing Drum Tower Hospital from 2014 to 2016, the positive role of clinical pharmacists in each link of perioperative pain management under the collaborative drug therapy management(CDTM) working mode is briefly described. METHODS To construct the CDTM perioperative pain management team, our hospital established a multi-disciplinary acute pain service management group which dominated by clinical pharmacists to manage the postoperative pain in an all-round way, and set up a treatment protocol in the treatment of patients. RESULTS After the establishment of the APS management group(2014-2016), the patients’ dynamic and static VAS scores dropped;the first three days of sleep quality improved;and the total incidence of adverse reactions were significantly lower than that in 2013(P<0.05)and no serious adverse reactions have been reported. CONCLUSION The APS group using the CDTM working model can control the pain better of the operation patients and help the patients get through the postoperative recovery better. The clinical pharmacist plays a very positive role in the perioperative pain management process under the CDTM working mode.