双相障碍患者围改良电休克治疗期用药评价及药物重整

Medication evaluation and reconciliation of patients with bipolar disorder in peri-modified electroconvulsive therapy

目的:评价双相障碍(BPD)患者围改良电休克治疗(MECT)期用药情况及药物重整。方法:收集采用MECT的BPD患者一般人口学及临床用药信息,依据《成人择期非心脏手术术前评估指南》、《电抽搐治疗原理与临床应用》和《双相障碍防治指南》,临床药师评价患者围MECT期用药风险因素,并提供相关用药建议进行药物重整。结果:300例BPD患者中,围MECT期用药风险因素分布依次为:19.00%使用药物≥5种、17.33%有不良用药习惯、15.33%使用高危药品、9.33%肝功能不全、8.00%为过敏体质、4.00%肾功能不全、3.67%年龄≥60岁;临床药师共提出用药建议及临床决策1065例次(医师142次、护士293次、患者630次),采纳率分别为71.12%、93.86%和100%;药物重整后我院MECT术后不良反应发生率为9.23%,低于文献报道的12.34%。结论:BPD患者围MECT期用药风险因素多;药物重整减少BPD患者围MECT期风险,促进用药安全。

Objective:To evaluate the medication of patients with bipolar disorder(BPD)during the peri-modified electroconvulsive therapy(peri-MECT)period and to reorganize the mediacation.Method:The general demographic and clinical medication information of bipolar disorder patients with MECT was collected.According to the Guidelines for Preoperative Evaluation of Adult Elective Non-cardiac Surgery,Principles and clinical application of electroconvulsive Therapy and Prevention and Treatment of Bipolar Disorder,the risk factors of patients with peri-MECT medication were evaluated and the medication reconciliation were recommended by the clinical pharmacists.Results:A total of 300 patients were included in this study.The distribution of risk factors for patients with peri-MECT medication were as follows:more than five kinds of drugs(19.00%);bad medication habits(17.33%);high-risk drugs(15.33%);liver dysfunction(9.33%);allergies(8.00%);renal dysfunction(4.00%);older than sixty years old(3.67%).In this study,clinical pharmacists in our hospital provided medication recommendations and clinical decisions for 1065 times(142 times for doctors,293 times for nurses and 630 times for patients).The acceptance rates were 71.12%,93.86%and 100%respectively.After medication reconciliation,the incidence of adverse reactions after MECT in our hospital was 9.23%,lower than 12.34%as reported in the literature.Conclusion:There are many risk factors in peri-MECT medication for patients with bipolar disorder.Medication reconciliation reduces the risk of bipolar disorder patients in peri-MECT period and promotes drug safety.