引入PCNE分类系统对消化内科药物相关问题进行探索与实践

PCNE classification system for drug-related problems in the Department of Gastroenterology

目的 运用欧洲医药保健网(PCNE)分类系统对消化内科药物相关问题进行总结和讨论,为今后临床药师药学工作的开展及工作方向提供参考。方法 以我院消化内科临床药师医嘱审核记录及审方软件调取的2018年1月1日-2021年6月30日消化内科医嘱问题为研究对象,采用PCNE分类系统(V9.0)评估药物相关问题(DRPs),并对发生DRPs 的类型、原因、干预方案、干预方案的接受程度及DRPs状态等进行分析。结果 本研究涉及患者共计386人,药物相关问题共计434条,平均每人用药问题为1.12条。实际干预434条,干预成功率为97.24%;医嘱审核记录中相关药物分类排名前三的是消化系统药物(34.10%)、抗感染药物(24.88%)及糖盐类药物(20.28%);DRPs问题分类排名前三位的分别是不确定的问题或抱怨需要进一步说明(35.25%)、可能发生药物不良事件(30.18%)、治疗效果不佳(16.82%)。结论 PCNE分类体系引入医嘱审核工作能够提升临床药师发现和解决DRPs的能力,明确相关科室主要的药物相关问题,提高临床药师在临床的药学监护效率,确保临床合理用药。

Objective To summarize drug-related problems in the Department of Gastroenterology with PCNE classification system to provide reference for clinical pharmacists’ work in the future.Methods We reviewed the medical order review records and prescriptions in the Department of Gastroenterology from January 1st,2018 to June 30th,2021.Drug related problems (DRPs) were evaluated by PCNE (V9.0) classification system.The types,causes,intervention schemes,acceptance of intervention schemes and the status of DRPs were analyzed.Results Totally 386 patients were involved:434 DRP cases,with an average of 1.12 DRP for each patient.All 434 DRP cases were intervened,with a success rate of 97.24%.The top three categories of related drugs in medical order review records were digestive system drugs (34.10%),anti-infective drugs (24.88%),and sugar and salt drugs (20.28%).The top three DRPs were:uncertainty or complaints awaiting further explanation (35.25%),possible adverse drug events (30.18%),and poor treatment effect (16.82%).Conclusion PCNE classification system helps clinical pharmacists to improve their ability to find and solve DRPs in relevant departments,improve the pharmaceutical care efficiency,and ensure rational drug use.