临床药师参与老年肺部感染合并结构性肺病患者会诊的回顾性分析

Retrospective analysis of clinical pharmacists involvement in consultations for elderly patients with pulmonary infection complicated with structural lung disease

目的:介绍临床药师在临床参与优化老年结构性肺病患者肺部感染抗感染治疗方案的临床药学实践。方法:回顾性分析国家电网公司北京电力医院临床药师于2018年9月-2019年9月针对结构性肺病患者开展的抗感染会诊病例。统计患者年龄、肺部感染类型、会诊方法、临床医师对抗感染方案的采纳率、病情好转率等。结果:共会诊29例次,涉及患者22例,平均年龄(82.3±8.7)岁。经验性会诊20例次,占69.0%(20/29);针对明确的多重耐药菌会诊9例次,占31.0%(9/29)。临床药师会诊时制订的抗感染方案被临床医师采纳28例次,采纳率为96.6%(28/29)。治疗后患者病情好转率达81.0%(17/21)。结论:由临床药师与临床医护人员组成医疗团队,优化老年肺部感染合并结构性肺病患者的治疗方案,可提高临床医疗质量,有利于患者早日康复。

Objective:To introduce the practice of clinical pharmacists involvement in the development of anti-infective regimens for elderly patients with pulmonary infection complicated with structural lung disease.Methods:A retrospective analysis was made on the anti-infective regimens for patients with structural lung disease recruited from the Beijing Electric Power Hospital of State Grid Company of China from September 2018 to September 2019 and received medical consultation from clinical pharmacists.Data were recorded concerning patient age,types of lung infections,consultation methods,acception rate of anti-infective regimens by clinical physicians,and improvement rate of the disease.Results:There were a total of 29 case times of consultations involving 22 patients,with an average age of(82.3±8.7)years.Of the 29 case times of consultations,20 were empirical consultations,accounting for 69.0%(20/29).There were other 9 case times of consultations that were directly targeted to multi-drug resistant bacteria,accounting for 31.0%(9/29).There were a total of 28 case times with clinical pharmacists involvement in the development of anti-infective regimens,with an acception rate of 96.6%(28/29).After treatment,the improvement rate of the disease reached 81.0%(17/21).Conclusion:Medical teamwork involving physicians,nurses and pharmacists plus regimen optimization in the treatment of elderly patients with structural lung disease and pulmonary infection could improve the quality of medical care and is beneficial to early recovery of patients.