欧洲药学监护网络基金会分类系统在老年2型糖尿病高血压病人药物相关问题中的应用

Application of pharmaceutical care network Europe classification system to drug-related problems in type2 diabetes elderly patients with hypertension

目的将欧洲药学监护网络基金会(PCNE)分类系统用于临床病例中,探讨PCNEV8.02分类系统在老年2型糖尿病高血压病人相关问题中的应用。方法选取2019年1—12月南京医科大学附属老年医院2型糖尿病高血压老年病人176例,采用PCNE对其用药相关性问题进行分析,并对两个具体案例药物相关问题(DRPs)的类型、原因、干预、干预接受程度及DRPs状态进行系统分析。结果参与者男性114例(64.8%)。年龄为(72.8±9.41)岁。用药种数(7.77±2.55)种。最常使用的抗糖尿病药物是二甲双胍(111例,占63.07%)和阿卡波糖(87例,占49.43%)。钙离子拮抗剂是最常用的降压药,有131例(74.43%)服用。97例(55.11%)使用了抗血小板药物。112例(63.64%)服用调血脂药物。总共确定了385个药物相关问题。与药物相关的问题的数量为(2.19±0.87)个。最常见的药物相关问题是药物的相互作用(39.22%),存在适应证未给相应的药物治疗(26.49%)和选药不适宜(7.79%)。结论临床药师通过PCNE分类系统可系统地、规范化地对病人实施药学监护,能及时发现和解决DRPs,确保临床用药的安全、有效、合理。

Objective To apply the pharmaceutical care network Europe association classification system(PCNE V8.02)to clinical cases,and to explore its application in the elderly patients with type 2 diabetes and hypertension.Methods One hundred and seventy-six elderly patients with type 2 diabetes and hypertension in the Affiliated Geriatrics Hospital of Nanjing Medical University from Janu⁃ary to December 2019 were selected to analyze the drug-related problems(DRPs)by PCNE.The types,causes,interventions,interven⁃tion acceptance and DRPs status of two specific cases were analyzed systematically.Results There were 114 male participants(64.8%).The age was(72.8±9.41)years old.The number of drug species was(7.77±2.55).The most commonly prescribed antidiabetic medications were metformin(111 cases,63.07%)and acarbose(87 cases,49.43%).Calcium antagonist was the most commonly pre⁃scribed antihypertensive drugs,131(74.43%)participants used them.Antiplatelet drugs were prescribed to 97(55.11%)patients.Lip⁃id-Lowing Agents were prescribed to 112(63.64%)patients.A total of 385 drug related problems were identified.The mean number of drug related problems was(2.19±0.87).The most frequent types of DRP were potential drug-drug interaction(39.22%),no correspond⁃ing drug treatment for indications(26.49%)and inappropriate drug selection(7.79%).Conclusion Through PCNE classification sys⁃tem,clinical pharmacists can carry out pharmaceutical care for patients systematically and normatively,discover and solve DRPs in time,and ensure the safety,effectiveness and rationality of clinical medication.