临床药学服务平台中用药建议模块的应用

Application and exploration of medication recommendations module based on the clinical pharmacy service platform

目的探讨“临床药学服务平台”中用药建议子模块的功能与应用,改进临床药师的专科工作内容及方法,促进药物合理应用。方法采用中国科学技术大学附属第一医院自主开发的“临床药学服务平台”中临床药师模块下的用药建议子模块,回顾性统计与分析2016年5月至2018年2月中国科学技术大学附属第一医院妇产科临床药师用药建议的内容,对病区分布、干预药物的种类与例次、采纳情况、不合理用药类型等方面进行归纳整理,并进一步探讨提高用药建议采纳率的措施。结果妇产科的用药建议主要分布在产科病区(43例,40.95%)、妇科肿瘤病区(11例,10.48%)、普通妇科病区(51例,48.57%)三个病区。干预药物中,例次最多的是抗菌药物,占妇产科用药建议总例次的65.71%,主要有头霉素类和二代头孢菌素类。用药建议的采纳类型分为四种,分别为建议状态(53例,50.48%)、医师申诉(8例,7.62%)、药师同意用药(1例,0.95%)及已接受(43例,40.95%)。不合理用药类型中排前三位的分别是用法用量不适宜(44例次,38.94%)、用药疗程过长(23例次,20.35%)、遴选药物不适宜(15例次,13.27%)。结论“临床药师服务平台”提高了临床药师工作效率,加强了临床药师与临床医师的沟通。临床药师通过提出用药建议的方式参与临床诊疗工作,有利于促进临床合理用药,使病人的治疗方案更为安全、有效、经济。

Objective To explore the function and application of the medication recommendation submodule of the clinical pharma?cist module in the Clinical Pharmacy Service Platform,to improve the content and methods of the clinical pharmacist's special work,and to promote the rational use of drugs.Methods The contents of the medication recommendations under the clinical pharmacist module in the“Clinical Pharmacy Service Platform”independently developed by The First Affiliated Hospital of University of Science and Technology of China.The clinical pharmacists in Department of Obstetrics and Gynecology,The First Affiliated Hospital of Uni?versity of Science and Technology of China from May 2016 to February 2018 were retrospectively analyzed.The distribution of the dis?ease area,the types and cases of intervention drugs,the adoption of the drugs and the irrational drug types were summarized and sort?ed out,and probed into the measures to improve the adoption rate of medication recommendations.Results The medication recom?mendations of gynecology and obstetrics were mainly distributed in three areas,gynecologic diseases(43 cases,40.95%),gynecological tu?mors(11 cases,10.48%),and common gynecological diseases(51 cases,48.57%).Among the intervention drugs,antimicrobial drugs were the most frequently reported,accounting for 65.71%of the total recommended drug use in gynecology and obstetrics,mainly the cephamy?cins and the second generation of cephalosporins.The adoption types of the medication recommendations were divided into four types,in?cluding recommended state(53 cases,50.48%),physician appeals(8 cases,7.62%),pharmacists agreed to use drugs(1 case,0.95%)and accepted(43 cases,40.95%).Among the irrational drug types,the top three were inappropriate dosage(44 cases,38.94%),long course of treatment(23 cases,20.35%)and improper selection of drugs(15 cases,13.27%).Conclusion The Clinical Pharmacy Service Platform improves the efficiency of clinical pharmacists and strengthens the communication between clinical pharmacists and clinicians.The clini?cal pharmacists take part in the clinical diagnosis and treatment by putting forward the medication recommendations,which is helpful to promote the rational use of drugs in clinic and made the treatment scheme of patients more safe,effective and economical.