持续性药学服务在妇科肿瘤化疗患者中的应用实践

Application of Continuous Pharmaceutical Care in Gynecological Tumor Patients Undergoing Chemotherapy

目的建立妇科肿瘤化疗持续性药学服务路径并分析应用效果。方法通过文献检索和北京妇产医院(以下简称我院)现状调研,建立妇科肿瘤化疗持续性药学服务路径,并以我院妇科肿瘤科2020年5月至2021年4月收入的173例化疗患者为研究对象进行效果观察,分为干预组和对照组。干预组按路径实施至少3个化疗疗程的持续性的药学服务,对照组实施常规用药指导及护理宣教。在第3程化疗当日采用问卷调查的方式比较两组患者对用药知识了解程度,采用床旁问诊和病历查询的方式获取患者药物不良反应(ADR)和用药错误(ME)发生情况并及时干预,用专用表格记录。结果最终纳入干预组和对照组患者分别为66、72名,两组患者基线特征比较差异无统计学意义(P>0.05);干预组患者对药物了解程度较对照组明显改善,总分[(14.121±1.398)∶(12.292±2.441)],F=25.734,P<0.001,差异有统计学意义。干预组患者给药与监测环节中ME较对照组明显减少,[9.1%(6/66)比40.3%(29/72)],χ^(2)=17.693,P<0.001,差异有统计学意义。ME级别大多为B级和C级,但也有3例E级ME,需及时干预以避免对患者造成进一步危害。结论妇科肿瘤化疗持续性药学服务路径的建立及应用有助于提高妇科肿瘤化疗患者对用药知识的了解程度,及时发现并干预ADR,预防ME。

OBJECTIVE To establish a continuous pharmaceutical care pathway for gynecological tumor chemotherapy and analyze its application effect.METHODS Through literature search and the current situation investigation of our hospital,the pathway of continuous pharmaceutical care pathway for chemotherapy of gynecological tumor was established.One hundred and seventy-three chemotherapy patients received from the department of gynecological tumor from May 2020 to April 2021 were divided into intervention group and control group.The intervention group carried out continuous pharmaceutical service for at least 3 chemotherapy courses according to the pathway,and the control group carried out routine medication guidance and nursing education.On the day of chemotherapy in the third course,the knowledge of drug use was compared by questionnaire survey.The adverse drug reactions and medication error were obtained by bedside and medical record inquiry,and recorded with special forms.RESULTS Finally,66 and 72 patients were included in intervention group and control group,there was no statistical significance in baseline characteristics between 2 groups(P>0.05).The understanding of drugs in the intervention group was significantly improved compared with that of the control group,with a total score of(14.121±1.398)vs(12.292±2.441),F=25.734,P<0.001,The difference was statistically significant.The medication error in the intervention group was significantly lower than that in the control group,and the difference was statistically significant 9.1%(6/66)vs 40.3%(29/72),χ^(2)=17.693,P<0.001.Most of medication error levels are B and C,but there are also 3 cases in level E,which need to be timely intervention to avoid further harm involved.CONCLUSION The application of the continuous pharmaceutical service pathway of gynecological tumor chemotherapy can improve the knowledge of the patients,discover and intervene the adverse drug events in time and prevent medication error.