药学门诊中双向转诊的实施与病例分析

Implementation and case analysis of bi-directional referral in pharmacist-managed clinic

目的介绍某三甲医院药学综合门诊双向转诊的工作内容及特点,分析当前的问题,为其他药学门诊的建立提供参考。方法介绍该院药学综合门诊双向转诊的工作流程、服务模式方面的经验。统计2019年7月1日至2021年6月30日某医院药学综合门诊双向转诊患者的一般情况、疾病情况、用药情况、药物治疗、转诊情况等相关问题。结果该院药学综合门诊通过双向转诊共接诊44例患者,转入37例次,转出19例次,75.00%的患者诊断有3种以上疾病,61.36%的患者使用5种及以上的药物,平均每位患者存在的药物治疗相关问题为1.48个。共识别出19例药物不良事件,为患者进行了13例次的药物剂量调整,换用药物8例次,增加药物6例次,停用药物5例次。结论临床药师通过建立与临床科室合作的药学综合门诊,参与门诊患者的药物治疗管理,可识别出患者药物治疗问题,保障患者合理用药。

Objective To introduce the working content and characteristics of pharmacist-managed clinic in a tertiary hospital,analyze the current problems,so as to provide reference for the establishment of other pharmacist-managed clinics.Methods The working process and service mode of bi-directional referral in pharmacist-managed clinic were introduced.The general conditions,diseases,medications,drug treatment and referrals in pharmacist-managed clinic from July 1,2019 to June 30,2021 were analyzed.Results The pharmacist-managed clinic received a total of 44 patients and completed 56 referrals;75.00% of patients had more than 3 diseases,and 61.36% of patients took more than 5 drugs at the same time.On average,each person has 1.48 medication-related problems.A total of 19 adverse drug events were identified,and 13 drug dosage adjustments were made for the patients,with 8 drug changes,6 drug additions,and 5 drug discontinuations.Conclusion Clinical pharmacists participate in the management of patients′ drug treatment and collaborate with physician by establishing pharmacist-managed clinic to identify patient drug treatment problems and ensure the rational use of drugs in patients.