一则利用药师服务患者流程进行门诊用药咨询实例

An example of using pharmacists’patient care process for outpatient medication consultation

目的:利用药师服务患者流程(pharmacists’patient care process,PPCP)完成1例哺乳期患者使用封闭疗法治疗腱鞘炎的用药咨询解答,验证其可实施性。方法:采用PPCP项目的五步分析法即收集、评估、计划、执行、跟进:监测和评价解答患者咨询。包括收集患者用药及临床相关信息;评估所咨询问题的重点部分;制定方案解决患者关注的药物治疗问题;通过患者教育提出药学监护建议;电话随访评估其用药安全性、依从性和有效性。结果:解答患者提问:腱鞘炎患者使用2%利多卡因2 mL加曲安奈德混悬液1 mL进行痛点封闭治疗不影响哺乳,但需要注意药学监护,防止可能发生的母乳减少等不良事件。结论:对比国内和美国部分关于用药咨询的文件,PPCP项目步骤更为精炼,能够明确用药咨询流程,保证患者更好更快地得到解答。

OBJECTIVE Use PPCP(Pharmacists’Patient Care Process)to complete the medication consultation on the treatment of tenosynovitis in breast-feeding patients with blocking therapy,and verify its feasibility.METHODS Five-step analysis method of PPCP,i.e.Collect,Assess,Plan,Implement,Follow-up:Monitor and Evalute,was employed for medication consultations.It was composed of collecting information about patient medication and clinical practice,assessing answers of key questions,formulating solutions to resolving the treatment issues of patient concerns,proposing pharmaceutical care recommendations through patient tutoring and evaluating drug safety,compliance and effectiveness through telephone follow-ups.RESULTS Addressing practical inquiries,tenosynovitis using 2%lidocaine 2 ml plus triamcinolone acetonide suspension 1 ml for blocking therapy does not affect breastfeeding.However,it is necessary to pay attention to pharmaceutical care to prevent possible adverse events of reduced breast milk.CONCLUSION As compared with some domestic and US documents on medication consultations,the procedures of PPCP are more refined so as to better clarify the medication consultation process and ensure better and faster answers for patients.